Declaration by Applicant

I have read and understood the funding conditions attached to this scholarship grant and agree to abide by those conditions. Specifically:

1. Upon completion of the course of study, or annually if the course of study has a duration of longer than one year, a copy of your academic report and a short written evaluation of the course of study (not more than 100 words).
2. An expenditure statement with copies of invoices and receipts for the amount of the grant (for example, invoice from the school, receipts for books, etc).
3. Attendance and/ or presentation at Foundation functions if requested.
4. Immediate notification to the Foundation of major changes to the proposed course of study and proposed completion date. The Foundation reserves the right to modify or suspend funding at its own discretion if changes to the proposed activity do occur.
5. Assume all responsibility for any tax payments that result from receiving a grant.
6. Notification of change of contact details.
7. I also give permission for the Ipswich Hospital Foundation to include information on the award of this grant in its publications and media releases.