Higher Education University Hardship Fund (formerly ALF) Academic Year 2015/16 Closing date 27 th May 2016

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1 Higher Education University Hardship Fund (formerly ALF) Academic Year 2015/16 Closing date 27 th May 2016 IMPORTANT: The University Hardship Fund has a limited source of funding and will close prior to the above date should funds be exhausted sooner. Please note: under those circumstances it may not always be possible to assess an already submitted application. Application for contribution towards certain course related costs only for part-time study (undergraduate & postgraduate) Contact us Student Support Fund Team Student and Learning Support University of Sunderland 1 st Floor Edinburgh Building Chester Road Sunderland SR1 3SD Telephone : /

2 Who can apply? Guidance notes please detach, read and retain for your information before completing this form Your household gross income should be less than 28,066 (after disregards*) to be eligible for help. *Disregards - 2,000 for partner - 2,000 for eldest child - 1,000 for each subsequent child. You must have settled status in the UK and have been ordinarily resident in the UK for 3 years before your course. You must not be deemed unfitted for student funding by Student Finance England (SFE) or any other student body. In addition, you must not be under investigation by SFE or any other student finance body. You must be a registered student at the University of Sunderland or studying a franchised course at a University of Sunderland partnership college. For courses starting before 1 st Sept part-time students must be studying at least 50% of a full-time equivalent (FTE) course. Students with a disability preventing them from studying at least 50%, can apply provided they are studying at least 25% FTE. For courses starting on or after 1 st September part-time students must be studying at least 25% FTE. Undergraduate students must be studying a course which is designated to receive financial support from the student finance body and they personally must be identified as eligible to receive financial support where applicable. You must have applied for all funding available to you. You must have taken the full statutory student support available to you from SFE unless your fees are being met by sponsorship. If you are not working and are fit for work you need to have applied for an earnings replacement benefit e.g. JSA /ESA/Universal Credit. Postgraduate and ELQ students must have made adequate financial provision for tuition fees, childcare provision and living costs prior to starting their course. Where do I send the form? Completed forms should be submitted to: Student Support Fund Team, University of Sunderland, Student & Learning Support, The Gateway, 1 st Floor Edinburgh Building, Chester Road, Sunderland, SR1 3SD. How long does it take? We will usually you with the result of your application within 4 weeks of receiving your completed form. However, due to the high volume of applications received at busy periods this decision time may be extended. If you do not complete all parts of the form or provide the evidence required this may also delay an assessment. Applications can only proceed if all evidence is satisfactory. If your circumstances are complex we reserve the right to request additional information. How are payments made? Payments will be made by direct credit and will be credited to the bank account registered on e:vision. Please ensure that your correct bank details are registered before presenting your application. This will avoid any unnecessary delays in payment. Please note: The University cannot be held responsible for late payment if bank details are either not registered, registered incorrectly or due to University system errors. How to register/change your bank account details Go to e:vision via link Go to the My Finance section. Go to set up Bursary/Scholarship payment. Follow the steps to register or change your bank details. How can I contact the Student Support Fund Team? If you are not sure how to answer any of the questions on the application form please contact us. By at By telephone: /2946. In person by visiting the Student Support Fund Team, The Gateway, 1st Floor Edinburgh Building, Chester Road, Sunderland, SR1 3SD

3 Date of receipt (for University use only) Part 1a: Your Personal Details 1. Is this your first application to the Fund in the academic year 2015/16? Please note: Only one application per academic year can be accepted for this Scheme. 2. Your University student registration number 3. Your title Mr Mrs Miss Ms Other 4. Your first name/s (in full) 4. Your surname (in full) 6. Gender Male Female 7. Date of birth (DD/MM/YYYY) 8. Your age in years on 1 st September Your correspondence address when attending University 10. Do you live at this address all year? (If you normally spend the vacations in another property e.g. with parents you should tick ) 11. If you have answered to the above question, please give your vacation address Part 1b: Your Contact Details We will use the following information to contact you. If your details change after you have handed in your application you must let us know 12. Telephone number Mobile Land line 13. Student address (We will use this address to contact you about your application)

4 Part 2: Personal Status and Accommodation Details 14. About your accommodation (please tick the boxes which apply to you) Living in parental home Living in Halls of residence Living in a shared house e.g. student house - How many adults live at this address including yourself? Home owner Living in rented accommodation (other than a student house) -If you are the owner or official tenant of the property, do you have any adult dependents living with you e.g. adult children, boarders/lodgers Please give details non 15. About your living arrangements (please tick the boxes which apply to you) Living alone Living alone with children With husband, wife, civil partner or partner (include partner if working away) - Are they a student? Part-time Full-time Uni/College - Please provide their SFE documents with full breakdown of loans/grants - Have they applied to a hardship fund this academic year? -How much did they receive? Living with parents or legal guardian Other 16. Do you have any children who are financially dependant on you? N.B. If your children are in fulltime Further Education (FE) they will be counted as dependents up until their 20 th birthday. They must also have started their course before their 19 th birthday. 17. Do the children live with you? (Please give details) Full name Full name Full name (Please continue on a separate sheet) If you have shared care, please provide details of care and copy of birth certificate for each child. Date of birth Date of birth Date of birth. Male/female 18. Do you have shared care of the children? 19. Do you have a disability or medical condition which prevents you from working? If you have answered yes you will need to provide a GP sick note or provide benefit notices.

5 Part 3: About Your Study 20. Course title 21. Faculty e.g. Arts Design & Media 22. Do you already hold an equivalent or lower level qualification (ELQ) to the one you are studying now? 23. This year have you applied to SFE for either a Tuition Fee Loan and/or Grant? If you have not applied for student finance please tell us the reason in the space below 24. Is this a franchised University course i.e. run at a different institution from the University of Sunderland? 25. If please give the name and address of the institution where you are studying 26. What is the official duration of your course? 27. Which year are you in now? years 1 st 2 nd 3 rd 4 th 28. Is this your final year? 29. Is this a repeat year? 30. What level is your course? Foundation Undergraduate Postgraduate How many weeks does your course cover? weeks Which days of the week are your compulsory days of attendance? Mon Tues Wed Thurs Fri If your compulsory attendance is more than one day per week You need to provide your official timetable as evidence.

6 Part 4: Details of Income Income You must provide photocopied evidence. See Evidence Checklist in Part 6. Employment Gross income from salary/wages before Deductions Amount received before tax (gross income) Husband, wife, partner or You civil partner annual annual Self employment Tax Credits Savings and investments Bank and building society gross interest (before tax) Property Income from property lettings or rent Other Any other type of income -Please give details Benefits You must provide evidence. See Evidence Checklist in Part 6. You (weekly) Council Tax Benefit Husband, wife, partner or civil partner (weekly) Housing Benefit Job Seekers Allowance (JSA) Income Support Employment and Support Allowance (ESA) Universal Credit Any other benefits Part 5: Details of course related costs considered How are you funding your tuition fees? Please tell us in the space provided Duration of course for this current academic Year (in weeks) Travel costs (undergraduate and postgraduate) Books/Materials (undergraduate and postgraduate) Registered Child Care Costs (undergraduate only) daily annual daily annual a NB: If you are studying a Primary ITT Programme and on placement outside the Tyne & Wear area you may be entitled to claim travel expenses from the Faculty of Education & Society. Please provide an estimate of annual costs. Please note: ELQ and Postgraduate Students registered child care costs will not be be considered)

7 Part 6: Evidence Checklist (photocopies only) - Please provide evidence where applicable (photocopies only) Unfortunately we cannot accept original documentation Statutory support letter from SFE Your official course timetable If your compulsory attendance is more than one day per week please provide your course timetable as evidence. Income from employment Please provide pay slips for you and your partner. If you are paid monthly, please provide the latest 3 months pay slips. If you are paid weekly, please provide the latest 4 weeks pay slips. Income from self employment If you or your partner are self employed, please provide your latest certified accounts plus a full copy of your 2015/16 tax credits awards notice plus 2016/17 depending on the timing of your application. Tax Credits If you receive tax credits please provide a full copy i.e. all pages of your award notice for 2015/16 plus 2016/17 depending on the timing of your application. The award notices should reflect the circumstances you have told us about in your application. Income from savings and investments This includes bank and building society gross interest (before tax) or from any other investment income. Bursary Payments e.g. Scholarships, awards, help towards exhibitions, bursaries or any other allowances. Benefits please provide copies of your award notices e.g. housing benefit, council tax benefit, income support covering the academic year 2015/16 or 2016/17 depending on the time of your application. If you are not working Students are expected to have applied for all benefit entitlements before applying to this Fund. If you are not working and are fit for work you must have applied for an earnings replacement benefit such as JSA/ ESA/Universal Credit. Please provide your award notice. If you have been refused benefits please provide evidence. Council Tax tice for period April 2015 to March 2016 (or April 2016 to March 2017) depending on the timing of your application Please provide your Council Tax notice or exemption certificate. Other Income e.g. boarders/lodgers, rental income from property, bank interest, dividends from investment or any other income. Postgraduate Funding e.g. loan agreement for Professional and Career Development Loan (PCDL) : Research Council Grant: Research Student Grant: Scholarship: Other. Registered Child Care Costs (undergraduate only) Please provide a letter from your child care provider confirming child care.

8 Part 7: Data Protection and Confidentiality Data Protection Act 1998 The University of Sunderland is a data controller in terms of the 1998 legislation. The Student & Learning Support Department follows the University policy in matters of data protection, particularly with regard to the confidential nature of sensitive personal data. This sensitive personal data will be used solely within the department for needs assessment, statistical purposes and electronic records keeping. It will not be passed to any third party without your consent, except when the University is required to do so by law, e.g. to Auditors. All documentation relating to applications will be held for audit purposes for a period of seven years. Any formal enquiries concerning the use of data noted here should be addressed to: Data Protection Officer, University of Sunderland, 4 th Floor, Edinburgh Building, Chester Road, Sunderland SR1 3SD. Confidentiality Applications are seen by the committee and Student and Learning Support Services staff and if necessary the University Hardship Fund Appeal Panel Members. It may be necessary for additional supporting information to be sought from other University staff in order for the Appeals panel to reach a decision. Part 8: Declarations... I certify to the best of my knowledge that I meet the following conditions -Please tick the relevant box I am a UK national/british citizen; or I am settled within the United Kingdom (UK) (i.e. I have the Right of Abode in the UK or been awarded Indefinite Leave To Remain) or settled on the first day of the first academic year of the course I have been recognised by the UK Government as a Refugee. or I have been granted Humanitarian Protection (HP) by the Home Office or I am an EEA or Swiss Migrant Worker or the family member of an EEA or Swiss Migrant Worker (please tick if you intend to continue working while studying ) or I am an EU national who has been ordinarily resident in the UK for the three years prior to the first day of the first academic year of my course, or I am the child of a Swiss national, or I am the child of a Turkish worker. I also confirm the following - please tick the relevant boxes I confirm that I am supporting the children named in this application form. I confirm that I am not living with a spouse/partner I confirm that I am registered upon and in attendance on the course described in this application form. C

9 ...Declarations continued I confirm that the contents of this application are true and correct and that I have read and understood all of the information on this form. I confirm that I have not been deemed unfitted for student finance from Student Finance England or any other student finance body. I confirm that I am not currently under investigation by Student Finance England or any other student finance body which may affect my entitlement to student finance. I understand that if the supporting evidence provided is inconsistent or contradictory my application cannot proceed until all is clarified. I understand that if evidence is not provided my application cannot proceed. I understand that misrepresentation of information will automatically disqualify my application and may also lead to University disciplinary procedures and/or civil/legal action. I further undertake to repay any loans/grants obtained by me as a result. I understand that the closing date of the Scheme will be 27 th May 2016 or sooner if funds are expended and that applications will not be accepted or assessed beyond that point. I confirm that I will input my bank account details onto the University s e:vision system before presenting this application and that the University cannot be held responsible for delayed payment if the details are input late or registered incorrectly or through system errors. I understand that all documentation relating to my application will be held for audit purposes for a period of seven years. Name (CAPITALS) Signature Date Don t forget to register your bank account details on the University s e:vision! Please send your completed form together with photocopied evidence to. Student Support Fund Team University of Sunderland Student & Learning Support 1 st Floor Edinburgh Building Chester Road Sunderland SR1 3SD -Please remember to use the correct postage!

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