FEES CONCESSION APPLICATION FORM

Please fill out all the required fields below. 

Personal information is collected in accordance with CEWA Ltd's Privacy Policy. Your personal information will not be disclosed to a third party without your consent.

Parent/Guardian 1: Full Name*
Parent/Guardian 2: Full Name*
Please describe your change in circumstances/hardship
Please indicate whether the impact of these circumstances is expected to be applicable in the short-term, medium-term or long-term*

Income and Expenditure

Supporting evidence is required. 


INCOME

Parent/Guardian 1: Check all that apply*
Parent/Guardian 1: Upload latest Notice of Assessment (from Australian Taxation Office)*
No File Chosen
File uploads may not work on some mobile devices.
This document is mandatory to be eligible to be considered for Fee Support
Parent/Guardian 1: Upload Latest Payslip*
No File Chosen
File uploads may not work on some mobile devices.
Parent/Guardian 1: Upload Second Latest Payslip*
No File Chosen
File uploads may not work on some mobile devices.
A$
Parent/Guardian 1: Upload Profit/Loss Statement*
No File Chosen
File uploads may not work on some mobile devices.
A$
Centrelink Benefit (Check all that apply)*
A$
Upload Centrelink Payment Statement*
No File Chosen
File uploads may not work on some mobile devices.
Parent/Guardian 2: Check all that apply*
Parent/Guardian 2: Upload latest Notice of Assessment (from Australian Taxation Office)*
No File Chosen
File uploads may not work on some mobile devices.
This document is mandatory to be eligible to be considered for Fee Support
Parent/Guardian 2: Upload Latest Payslip*
No File Chosen
File uploads may not work on some mobile devices.
Parent/Guardian 2: Upload Second Latest Payslip*
No File Chosen
File uploads may not work on some mobile devices.
A$
Parent/Guardian 2: Upload Profit/Loss Statement*
No File Chosen
File uploads may not work on some mobile devices.
A$
Centrelink Benefit (Check all that apply)*
A$
Upload Centrelink Payment Statement*
No File Chosen
File uploads may not work on some mobile devices.
Additional sources of household income:*
A$

EXPENDITURE


Enter 0 if expense not applicable

A$
Upload mortgage statement / rental payment receipt*
No File Chosen
File uploads may not work on some mobile devices.
If expense is zero, please upload statement/evidence
A$
A$
A$
A$
A$
A$
A$
A$
A$
A$

Assets and Liabilities

ASSETS


Enter 0 if Asset not applicable

A$
Current Value (estimate)
A$
Current Value (estimate)
A$
Current Value (estimate)
A$
Current Value (estimate)
A$
Current Value (estimate)
A$
Current Value (estimate)
A$
Current Value (estimate)
A$
Current Value (estimate)
A$
Current Value (estimate)
A$
Current Value (estimate)
A$
Current Value (estimate)
A$

LIABILITILES


Enter 0 if Liability not applicable

A$
Current Amount Owing (estimate)
A$
Current Amount Owing (estimate)
A$
Current Amount Owing (estimate)
A$
Current Amount Owing (estimate)
A$
Current Amount Owing (estimate)
A$
Current Amount Owing (estimate)
A$
Current Amount Owing (estimate)
A$
Current Amount Owing (estimate)
A$

Contact Information

Preferred contact for the purpose of this application

Preferred contact for the purpose of this application*
Preferred day for appointment with Business Manager to discuss application*
Select all that apply
Preferred time for appointment with Business Manager to discuss application*
Select all that apply

Declaration

DECLARATION

Name of person signing on behalf of both parents/guardians*
I hereby declare that all statements contained in this application are true and correct and understand that false or inaccurate information in the application may result in the application being denied or any agreed concession being cancelled, reversed or modified.*

Sorry, applications cannot be considered unless you agree to this declaration.

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