ATSICHS Brisbane Jimbelunga IYHS

Young, Black and Proud Scholarship Application Form

How to apply

Step 1

Read the application form and the info pack and guidelines.

Step 2

Complete your application form online (see below form) OR by filling in the pdf document and emailing it to us at

Make sure that you fill in the application form and include the following:

  1. a photo of you (preferably 1MB-8MB size)
  2. Letter of support – from a community member, e.g. a teacher, coach or Elder
  3. Photo and Media Consent Form – click here to download

Well done for taking the time to complete this application. We can’t wait to read what a deadly person you are!

Online application

Please complete all sections below and provide additional documents where required. We will treat all information you give us on this application form confidentially. The information you provide will be used to assess your application and correspond with you.

  • Section 1 - Eligibility

    To be eligible to apply you will need to answer ‘Yes’ to all the requirements in the first two questions. If you do not answer 'Yes', unfortunately we cannot process your application.
    Haven’t had a health check? No worries you can book one in now, call 3240 8900 (press 4).
  • For example Yuggera, Waka Waka, Gubbi Gubbi etc.
  • Section 2 - Your Details

    Please note our preferred method of correspondence is email, otherwise all mail will be sent to your postal address.
  • Date Format: DD slash MM slash YYYY
  • Section 3 - Scholarship Stream

  • Section 4 - About You

    In the following section, please answer all the questions to support your application.
  • Please make sure your photo is suitable for social media and is a good size (preferably 1MB-8MB). Preferred file types are jpg or png.
  • Include details such as how long you’ve been involved, any special achievements or awards, names of teams etc.
  • You may wish to include a budget or approximate prices
  • Please note: if you have already received funding from another scholarship or were successful in a previous round of our scholarship, you may not be eligible for this round of the Young, Black & Proud Scholarship. Preference will be given to young people who have not received previous help or funding.
  • This may include personal and/or family disadvantage, financial hardship, academic or other achievements, particular talents or special interests (relevant supporting documents are welcome to be attached to the application).
  • Section 5 - Letter of Support

    A letter of support is required to be submitted with your application. It must be from someone who is not a close relative such as a teacher, coach or Elder. Make sure they include their name, contact details and how they know you. If you have more than one letter of support, please email additional documents to
  • Section 6 - Photo and Film Consent Form

    Please upload your completed photo and film consent form (available to download at the top of this page ( Remember if you are under 18, you will need a parent, caregiver or guardian to sign it.
  • Section 7 - Agreement

    We will treat all information you give us on this application form confidentially. The information you provide will be used only to assess your application and correspond with you.