OS Help Loan Application
Form: SSC – April 2015
1.
STUDENT DETAILS
STUDENT NUMBER
PHONE NUMBER
SURNAME/
GIVEN NAMES
FAMILY NAME
MAJOR/
COURSE TITLE
MINOR
COURSE DURATION
(SEMESTERS)
2.
EXPECTED COMPLETION
SEMESTER
OS HELP LOAN REQUEST
Have you received an OS-Help loan before from ECU or another provider?
 Yes  No
Select the loan type and amount you wish to apply for (Please note students are only eligible for one loan per six month period).
MAXIMUM
OTHER AMOUNT (PLEASE SPECIFY)
OS-HELP ASIAN DESTINATION
 $7635
 Other amount $
OS-HELP NON-ASIAN DESTINATION
 $6362
 Other amount $
Do you wish to apply for the supplementary Asian language study loan of $1018 to prepare for study in Asia?
Note this preparatory study cannot be counted towards your ECU degree.
 Yes
 No
Which Asian language(s) do you intend to undertake in preparation for your study overseas?
3.
BANK DETAILS
Bank Name:
Bank Branch:
BSB:
Account Number:
4.
OVERSEAS STUDY DETAILS
Are you applying to study overseas as:
 An exchange student?
A student who has been nominated to study at either an official ECU exchange partner university or another that they have selected for either a
semester or full year placement.
Complete sections 5 and 7 and return the completed form to Student Central
 A non-exchange student?
A student who has been approved by their Faculty to take short-term or session/yearlong study, fieldwork or a professional placement (internship,
clinical elective, etc) overseas which will count towards a course requirement for their ECU degree.
Complete sections 6 and 7 and return the completed form to your Faculty Student Information Office
5.
EXCHANGE STUDENTS ONLY – EXCHANGE PLACEMENT DETAILS
YEAR OF
TEACHING PERIOD OVERSEAS
COMMENCEMENT
DURATION OF STUDY  One semester  Two semesters
NOMINATED DESTINATION - COUNTRY
NOMINATED HOST
UNIVERSITY
6.
NON-EXCHANGE STUDENTS OVERSEAS STUDY DETAILS (STUDY TOURS, INTERNSHIP, PROFESSIONAL PLACEMENTS ETC.)
 Study tour
START DATE
 Other short term program (professional placement/Internship etc.)
END DATE
DURATION IN WEEKS
NAME OF UNIVERSITY/ ORGANIZATION
(IF APPLICABLE)
ECU UNITS AWARDED FROM OVERSEAS STUDY
UNIT CODE
UNIT NAME
ECU CREDIT VALUE
TOTAL CREDIT(S) TO BE GRANTED TO ECU COURSE
7.
APPLICANT DECLARATION
 I declare that the information supplied by me in this application is complete, true and correct in every particular and that I have not withheld any
relevant information.
 I consent to receiving electronic communication in relation to the OS-HELP application, as required.
 I understand that the information contained in this form is collected for the purpose of determining my entitlement to OS-HELP assistance. If I
provide false or misleading information in applications for OS-HELP, I understand that the University may be required to disclose information
contained in this form to the Australian Government. ECU may also be required to disclose my personal information as otherwise authorised or
required by Law.
 I agree to abide by the conditions on the OS-HELP Loan Scheme, which may be amended from time to time.
 I authorise the university to enrol me in approved study tour unit(s) (Exchange student will be enrolled as part of your application process).
STUDENT’S
SIGNATURE
DATE
STUDENT NUMBER
OFFICE USE ONLY
A. COURSE COORDINATOR TO COMPLETE FOR NON-EXCHANGE STUDENTS
If this study is in Asia, do you support for the intensive Asian language(s) preparatory training indicated in section 2
 Yes  No
Do you approve the units for credit as listed in section 6?
 Yes  No
ANY ADDITIONAL COMMENTS
COURSE COORDINATOR/
STUDY TOUR LEADER
SCHOOL
COORDINATOR’S SIGNATURE
DATE
RETURN FORM
TO FSIO
B. FACULTY STUDENT INFORMATION OFFICE TO COMPLETE
Does the credit approved by the course coordinator/study tour leader fit into the student’s course structure?
FSIO’S SIGNATURE
 Yes  No
RETURN FORM TO
STUDENT CENTRAL
DATE
C. STUDENT CENTRAL TO COMPLETE
 Australian citizen or humanitarian visa holder
 ≥ 15 credit points to complete after overseas study
 Commonwealth supported
 Course credit approval sighted
 Has completed 120 credit points- prior to commencement of overseas study
 Student will be full time during the overseas study
 Enrolment approved at overseas institution (exchange students only)
 Applicable unit/s enrolled
APPLICATION OUTCOME
 Approved
Forward to scholarships via RN
 Provisional Approval
To be reassessed; advise student
 Not Approved
Advise student
COMMENTS
SC’S SIGNATURE
DATE