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Who We Are
About Challenge
What We Do
Leuk the Duck
Who we are
Our Board
Our Ambassadors
Our Sponsors
Membership
About Membership
Become a Challenge Member
Update Member Profile
Member Stories
Our Programs
Emotional Support
Art Therapy
Massage Therapy
Music Therapy
Parent Support
Practical Support
The Challenge Family Centre
Holiday Accommodation
Hospital Support
Scholarships and Trusts
Social Support
Activities
Camps
Playgroup
Get Involved
Our Campaigns
#DoingItForJarrod
A Day in May
Biggest Aussie Pie Night
Lace up for Challenge
Ride4Kids
Tackling Childhood Cancer
Tie A Ribbon for Challenge
Our Events
Challenge Ball
Diamonds
Robert Allenby Golf Day/Dinner
How You Can Help
Fundraise for Challenge
Become a Volunteer
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Donate
The Christopher Wise Education Scholarship
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GENERAL INFORMATION
What is The Christopher Wise Education Scholarship?
Created in memory of Challenge Member Christopher Wise, whose enthusiasm and commitment to the pursuit of scholarly excellence was inspirational. Chris’s family are involved in the selection process and actively support this scholarship.
WHO CAN APPLY?
To apply for the Scholarship, you must be:
– A Challenge Member living with cancer or a life-threatening blood disorder
– Aged between 5 and 18 years inclusive
– Planning to commence or continue primary/secondary/tertiary education in the year you apply
Please note: You may reapply each year until 18 years of age, however applicants who have already received an award cannot reapply.
GUIDELINES FOR PRESENTATION
1. Complete ALL sections thoroughly
2. Answer ALL questions carefully
If you have any questions regarding this form, please contact the Challenge office on 03 9329 8474 or email mail@challenge.org.au
Applicants will be notified of the results of the Scholarship by mail.
Personal Information
Applicant Full Name
*
First
Last
Date of Birth
*
DD slash MM slash YYYY
Gender
Address
*
Street Address
Address Line 2
Suburb
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Contact Email
*
Does your family primarily speak a language other than English in the home?
*
Yes
No
If yes, what language does your family speak?
Medical Information
Diagnosis
*
Date of Diagnosis
DD slash MM slash YYYY
Hospital
*
Doctor
*
Has the patient suffered a relapse?
*
Yes
No
Academic History
Are you presently enrolled at school, a tertiary institution or any other academic institution?
*
Yes
No
What is the name of the School/Institution?
What year level are you currently undertaking?
What course of study are/will you be undertaking (if tertiary or specialised)?
During the period of study, what, if any, additional financial support do you expect to receive? (Including any other scholarships that you have received or are applying for).
For applicants 12 and over: In 200 words or less, tell us how the Christopher Wise Education Scholarship would help you pursue your education. PATIENT RESPONSE ONLY PLEASE
For applicants under 12: What do you like most about school? What do you like to do outside of school? What do you want to be when you grow up? PATIENT RESPONSE ONLY PLEASE
Should you receive funding from the Christopher Wise Scholarship, what would the funding go towards? Please be specific.
In order to be considered for this scholarship, applicants are required to complete a Challenge Membership Form. If you have not completed a current Membership Form, please contact the Challenge office.
I, the legal guardian of the child in which this application is for, endorse and support this application and can confirm that all the information provided in this document is true and accurate at the time of signing.
Signature
Reset signature
Signature locked. Reset to sign again
Should your child receive funding from The Christopher Wise Education Scholarship, would you as a parent/guardian allow a photo and caption to be placed on the Challenge website/social media pages?
Yes
No
Other Comments
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