Student Bursary Application Form

Transcription

1 Student Bursary Application Form Section 1: Personal Details First Name: Surname (Family/Last Name): Place of Birth: Date of Birth: DD MM YYYY Phone Number: Student No: Address Line 1: Address Line 2: City: Post Code: In which country have you been ordinarily resident in for the last three years? United Kingdom (UK) Another country within the EEA (Please name) Another country outside the EEA (Please name) Section 2: Course Information What course(s) are you applying to the Bursary Fund for? (Please list them in order of preference) Course Code Course Title Course 1: Course 2: Course 3: Do any of the courses above require you to seek authorisation from the relevant teaching department before enrolling? If the course code that you are interested in has an asterisk(*) next to it in our course guide, or you're asked to check your level before enrolling on the website then this means you need authorisation before joining the course. If Yes have you been authorised? If you have answered 'No' unfortunately the panel will be unable to consider your application. The panel meets every two weeks so if you do not currently have authorisation please apply once this has been granted.

2 Section 3: Bursary History Have you received a City Lit Bursary Before? If Yes please state the course title and explain how the course benefited you? Section 4: Income & Savings Do you currently receive any benefits? If Yes select from the list below Jobseeker s Allowance (JSA) Employment Support Allowance (ESA) Income Support (IS) Working Tax Credit (WTC) Housing Benefit/Support (HB) Council Tax Benefit/Support (CTS) Pension Guarantee Credit (PGC) Universal Credit (UC) If you do receive any of the above benefits how much do you receive? Benefit (e.g. JSA) Weekly Amount Fortnightly Amount Monthly Amount 1: 2: 3: What is your current employment status? Employed Self-employed Unemployed - Seeking work Unemployed - Not seeking work If you are employed or self-employed how much do you earn and how often? You must attach proof of your financial income with your application. Amount: Frequency (e.g. weekly): Do you have a spouse / partner that supports you financially? If Yes what is their source of income and how much per month? You must attach proof of their monthly financial income with your application. Source (e.g. employed): Amount: If you are single, not working and not claiming benefits how are you supporting yourself financially? If someone else is supporting you financially please explain who they are and how much financial support they are giving you per month. You must attach proof of their monthly financial income with your application.

3 Section 4: Income & Savings (continued) Do you have a private or state pension? If Yes which pension type and how much per month do you receive? You must attach proof of your pension income with your application. Pension type (e.g. state): Amount: Do you have any savings? If Yes how much savings do you have? You must attach proof of your savings with your application. Amount: Section 5: Reasons For Course Selection Why do you want to do the course(s) you are applying for? How will studying this course(s) improve your career prospects, academic aspirations or personal progression? Your answer must be at least 150 words in length. You may attach additional pages if needed. Section 6: Academic History Do you have any qualifications already? If No please go to section 7 If 'Yes' what qualifications? (Please list the most recent first)

4 Section 7: Personal Circumstances Please outline in detail any exceptional circumstances or barriers you have to learning/education? Your answer must be at least 250 words in length. You may attach additional pages if necessary.

5 Section 8: Evidence Checklist If you are on benefits have you attached recent proof? Please ensure that all documents you provide are dated within the last six months. If you are unable to secure a current benefit letter you can attach a fully completed City Lit 'Evidence of Concessionary fees' pro-forma instead. The pro-forma is available for download here: Have you attached a recent bank statement? In order to support the information you provided in Section 4 please provide an accompanying bank statement for the last month prior to today's date. Have you attached any other relevant documentation you think would be beneficial? E.g. pay slips, rent statements, medical / home office letters etc. Yes No Section 9: Student Declaration I've answered every question honestly and to the best of my ability, Informed you of all my income and savings ensuring all information I've provided is correct. Student Signature: Date: DD MM YYYY Thank you for Submitting your Bursary Application Please be aware of the following important information: The bursary panel meet every two weeks (Please check the bursary panel calendar to find out when the next meeting will be). Once the panel has met and processed all applications that were submitted for that round you should receive your outcome by the end of the week either by phone or . Submitting a bursary form does not hold your place on a course, but please do not enrol before you receive an answer from the panel as bursaries can't be applied retrospectively (after enrolment has taken place). You cannot apply for a bursary for a course that has already started, is full or you have not received authorisation for. If you require any further information, clarification or need help completing the form please call or advice@citylit.ac.uk where a member of the Information, Advice & Guidance team will be happy to help. Our office is open Monday to Friday from 12pm until 7pm. City Lit where London learns...