Application Received Date BURSARY FUND APPLICATION FORM 2016-17 Please complete this Application Form and submit it to Pearl Flanders, Student Services, in the Information, Advice and Guidance office. In case of queries please contact Pearl Flanders: Section A: Name & Address Please complete in capitals – Student Reference: Surname: First Name: Address: Telephone: E-mail: Postcode: Section B: Course(s) Details Course Code: Course Title: Full Fee: £ Concessionary Fee: £ Section C: Details of Financial Circumstances Please provide full details of what money you receive each month and attach copies of all relevant documents to support what you are saying. E.g. bank statements or benefit letters etc. Monthly Household Income Wages: Benefits: Any Other Income: Total: Section D: Supporting Documents We need to see copies of all of the following documents which apply to you. Please tick below to indicate the evidence you are providing. Your application will be delayed if you do not attach copies of the documents which support your claim. Bank Statement - This account should be the one in Benefit documents - If these are not dated □ □ your income stated above is paid into. within the last three months please also provide the bank statement. Payslip (if applicable) Medical document (if applicable) Other (Please give details) □ □ □ Section E: Supporting Statement In a few sentences please tell us why you are applying for a bursary. You should include information on any exceptional circumstances that mean you are unable to cover the fees stated overleaf. You should also tell us how you feel the course will benefit you.
Application Received Date BURSARY FUND APPLICATION FORM 2016-17 Please complete this Application Form and submit it to Pearl Flanders, Student Services, in the Information, Advice and Guidance office. In case of queries please contact Pearl Flanders: Section A: Name & Address – Please complete in capitals Student Reference: Surname: First Name: Address: Postcode: Telephone: E-mail: Section B: Course(s) Details Course Code: Course Title: Full Fee: £ Concessionary Fee: £ Section C: Details of Financial Circumstances Please provide full details of what money you receive each month and attach copies of all relevant documents to support what you are saying. E.g. bank statements or benefit letters etc. Monthly Household Income Wages: Benefits: Any Other Income: Total: Section D: Supporting Documents We need to see copies of all of the following documents which apply to you. Please tick below to indicate the evidence you are providing. Your application will be delayed if you do not attach copies of the documents which support your claim. □ Bank Statement - This account should be the one in your income stated above is paid into. □ Benefit documents - If these are not dated within the last three months please also provide the bank statement. □ Payslip (if applicable) □ Medical document (if applicable) □ Other (Please give details) Section E: Supporting Statement In a few sentences please tell us why you are applying for a bursary. You should include information on any exceptional circumstances that mean you are unable to cover the fees stated overleaf. You should also tell us how you feel the course will benefit you.
BURSARY_FUND_APPLICATION_FORM_2016-17_original.docx