Social Work Bursary: Academic year 2015/16 Application notes for students on undergraduate courses

Transcription

1 Social Work Brsary: Academic year 2015/16 Application notes for stdents on ndergradate corses These notes are for ndergradate stdents who are applying for a brsary for the first time. Please make sre yo complete the correct application form for yor circmstances - this form is only for stdents who are applying for a brsary for the first time. All application forms are available at: Changes to fnding explained The Department of Health have changed the way social work stdents are fnded from the 2013/14 academic year. All eligible ndergradate stdents are entitled to a Placement Travel Allowance (PTA) of (this amont will be paid pro-rata if yo are a part-time stdent), which can help yo towards the extra expenses incrred whilst yo are on yor placement. In addition yo may also be eligible for a brsary. (This is only available from Year 2 of yor corse). There is now a cap on the nmber of ndergradate stdents who can receive a brsary. Yor niversity/college will decide which stdents will be eligible to be assessed for a brsary so yo will not atomatically be entitled to one. Yo will initially be assessed for PTA only, and yo will be informed of any brsary entitlement once we have received notification from yor niversity/college that yo have been nominated for fnding. If yo received a brsary in the 2013/14 academic year and did not withdraw or defer from yor corse, yo will not fall into the new fnding arrangements. Completing the application Part 1 Yor details Please complete this section in BLOCK CAPITALS (inclding yor address) and tick all boxes appropriate to yor stats. This will help s hold the correct details for yo and contact yo if we need to. The names yo se here need to match the names yo give to yor niversity/college when yo register. Please provide details of all higher edcation qalifications yo hold. SWB Undergradate (new) application form (V2) 05/2015 Application form page 1 of 19

2 Part 2 Abot yor corse Please give s the exact name and level of the corse yo are stdying. If yo are nsre of the name, level or type of corse yo are stdying, please ask yor niversity/college. If yo are in the first year of yor corse, yo will not be eligible for a brsary. Yo will not be eligible for the brsary if yo are on an employment based corse. These are generally when yor stdies are being spported by yor employer, inclding direct Open University corses. If yo are repeating any modles of yor corse please tell s as we may need to contact yo and/or yor niversity/college regarding this. Part 3 Payment method Please give a bank accont that is in yor name (or a joint accont yo are named on). We will not pay any fnds into an accont that is not in yor name. Do not give the long nmber on yor card as we mst have the accont nmber and sort code. If yo are nsre what these are, please ask yor bank or bilding society. Part 4 Residency details A stdent mst satisfy the residency criteria before any brsary can be paid. Yo mst send original stdent finance awards, passports, residency permits, Home Office docments etc as we can not accept photocopies or scanned images. Yo mst also tell s if yo have lived otside of England anytime in the last three years leading p to the start of the first day of yor corse. This incldes living in Wales, Scotland or Northern Ireland. The fll residency criteria can be fond on or website at: If yo crrently have refgee stats or hmanitarian protection which has an expiry date then this mst be valid for the entire academic year (ntil 31 Agst 2016 for Atmn starters or ntil 31 December 2016 for Winter starters) otherwise yo are not eligible for any fnding. If yo do not have a passport or driving licence, please contact s on and tell s which type of photo identity yo have and we will let yo know if it is acceptable. Part 5 Other grants, brsaries, retainers or spport Please tell s abot any other fnding yo have applied for or will be receiving while stdying. Do not inclde applications from Stdent Finance England. SWB Undergradate (new) application form (V2) 05/2015 Application form page 2 of 19

3 Part 6 Employment details If yo are crrently working in the social care sector, please tick Yes and ask yor employer to complete section 6.2. If yo begin working in the social care sector after the start of yor academic year, yo mstdownload and complete this part of the application form again ensring it is signed by yor employer and send it to s withot delay. Please ensre yo post the original form to s as we cannot accept photocopies, faxed or scanned copies of the form. Part 7 Additional information Please se this space to give s any additional information yo feel is relevant to yor application. If yo are repeating or have changed yor corse, please provide as mch information as yo can abot this. Part 8 Data Protection We will treat all information yo provide in line with the Data Protection Act Yo can nominate one person to speak to s on yor behalf; we call this third party athorisation. If yo wold like to nominate someone please provide their first and last name, fll date of birth and tell s the relationship between this person and yorself. We se this information as secrity qestions so please ensre these are completed correctly. Part 9 Applicant s declaration Please ensre yo read and nderstand the declaration as it provides important information regarding what to do if yo stop yor stdies for any reason. Once yo have read the declaration and yo are happy with all the information yo have spplied, please complete yor name and then sign and date the declaration. We cannot accept photocopies of the declaration page. SWB Undergradate (new) application form (V2) 05/2015 Application form page 3 of 19

4 Part 10 Posting yor application to Social Work Brsaries Please list all original docments which yo are sending with yor application. Yo shold send any valable docments to s throgh a secre postal method sch as Special Delivery. Yo shold enclose a self-addressed, pre-paid Special Delivery envelope for the retrn of yor docments. This will allow yo to track the retrn of yor docments once they leave s. If yo do not send a pre-paid Special Delivery envelope, yor docments will be retrned to yo by standard second class post. If yo are sending yor application by Special Delivery, make a note of yor Special Delivery reference nmber. Please send yor application to: Social Work Brsaries Bridge Hose 152 Pilgrim Street Newcastle Upon Tyne NE1 6SN SWB Undergradate (new) application form (V2) 05/2015 Application form page 4 of 19

5 Social Work Brsary: Academic Year 2015/16 Application form for stdents on ndergradate corses who are applying for a brsary for the first time Important note: All eligible ndergradate stdents are entitled to a Placement Travel Allowance (PTA) of (this amont will be paid pro-rata if yo are a part-time stdent). In addition yo may also be eligible for a brsary if yo are nominated for fnding by yor niversity/college. 1 Yor details Official Use Box 1.1 Abot yo Are yo crrently receiving or have yo ever received a brsary (in fll or part) from the NHS Bsiness Services Athority (NHSBSA), General Social Care Concil (GSCC) or the Central Concil for Edcation and Training in Social Work (CCETSW)? No Yes The names yo se here need to match the names yo give to yor niversity/college when yo register and to Stdent Finance England. Title Mr Mrs Ms Miss Other Srname or family name First name Other names Previos names Date of birth DD / MM / YYYY Contact details Address Postcode Mobile phone nmber Alternative phone nmber SWB Undergradate (new) application form (V2) 05/2015 Application form page 5 of 19

6 1 Yor details contined 1.2 Qalifications Do yo have any degrees, diplomas or other qalifications at higher edcation level? No Yes Give details below. Do not inclde yor A Level qalifications. Name of qalification Sbject Date awarded University/college / / / / / / / / SWB Undergradate (new) application form (V2) 05/2015 Application form page 6 of 19

7 2 Abot yor corse 2.1 Corse details Fll name of social work corse. If yo are nsre, check with yor niversity/college admissions department. Is the corse employment based or college based? Placements are an essential component of yor stdy and do not necessarily mean yo are on an employment based corse (which is generally when yor stdies are being spported by yor employer, inclding direct Open University corses). If yo are nsre abot what type of corse yo are stdying, please ask yor niversity/college. College based Employment based Yo are not eligible for any fnding - do not complete this form Is the corse fll-time or part-time? Fll-time Part-time How many years will yor corse last? 2.2 Details where yo will be or are stdying Name of yor niversity/college Town/city 2.3 Stdy details Date yo first started yor corse MM / YYYY Year of corse yo are stdying in the academic year 2015/16 1st year Yo are not eligible for any fnding - do not complete this form 2nd year 3rd year Other Give details 2.4 Repeat stdy Will yo need to complete any social work modles from a previos year in the academic year 2015/16? No Go to part 3 Don t know Inform s in writing of details when yo know go to part 3 Yes Go to part 3 - we may need to contact yo or yor niversity/college abot this SWB Undergradate (new) application form (V2) 05/2015 Application form page 7 of 19

8 3 Payment method 3.1 Yor accont details If yo are nsre abot any of these details, check with yor bank or bilding society. If yo miss ot any details, yor payments may be delayed. All payments are made by Banks Atomated Clearing System (BACS). Yo mst provide yor accont details by completing the BACS form below. We will not make payments to an accont that is not in yor name. The accont mst be in the UK, be able to accept payments by direct credit and be in the name of the brsary applicant. If yo are nsre of these details, please check with yor bank or bilding society. We are nable to pay the brsary into prepaid card acconts. Payment by BACS means yo receive yor money faster, provided that yo spply the correct information. Please take the time to complete this section careflly and write clearly, otherwise it may delay or prevent payments. Name accont held in This mst be in yor name Accont details Bank/bilding society name Branch address Town/city Postcode Bank/bilding society sort code Accont nmber Roll or reference nmber Bilding society acconts only This is not yor credit or debit card nmber and may inclde symbols and letters. SWB Undergradate (new) application form (V2) 05/2015 Application form page 8 of 19

9 4 Yor residency details Read page 2 in the instrction notes before completing this section. 4.1 Residency and nationality details What is yor nationality? What is yor contry of birth? Date yo came to England DD / MM / YYYY OR Not applicable Main reason yo came to England OR Not applicable 4.2 Yor application to Stdent Finance England Did yo apply for a stdent loan from Stdent Finance England for the first year of yor corse? No Go to section 4.3 Yes Send yor original Stdent Finance England financial notification for the first year of yor corse with yor application - If yo no longer have the original notification, yo can reqest a copy from - Go to part 5 SWB Undergradate (new) application form (V2) 05/2015 Application form page 9 of 19

10 4 Yor residency details contined Time spent living otside England Have yo ever lived otside England dring the three year period leading p to the start of the first year of yor corse? No Go to section 4.4 Yes Give details below Contry yo lived in: From: / / To: / / Main reason yo lived there: Main reason yo retrned to England: Contry yo lived in: From: / / To: / / Main reason yo lived there: Main reason yo retrned to England: Contry yo lived in: From: / / To: / / Main reason yo lived there: Main reason yo retrned to England: If yo need more space to give details, se part 7 of this application form. Now go to section 4.4 SWB Undergradate (new) application form (V2) 05/2015 Application form page 10 of 19

11 4 Residency details contined 4.4 Yor residency stats in the UK Tick the description of yor or yor relative s residency stats in the UK and provide the evidence we ask for. For the prposes of this application, yor relatives are: yor spose/civil partner yor parents yor step parents yor legal gardians I am a UK national Send s yor original passport* OR I am a Eropean Union (EU) national Send s yor original passport* OR I or any of my relatives are Eropean Economic Area (EEA) or Swiss national migrant/frontier workers Please send s all of the following: applicant s original passport* migrant/frontier worker s original passport* evidence of three years employment history in the UK, dating back from 1 September immediately before the start of yor corse frontier worker s evidence of keeping a property in an EEA contry or Switzerland evidence of yor relationship to the migrant/frontier worker, for example, a birth/marriage certificate or adoption papers OR I am a non UK national with the following stats: If yo are applying with refgee stats or hmanitarian protection and yor Home Office papers have an expiry date, they mst be valid for the entire academic year. Expiry date of stats DD / MM / YYYY OR No expiry date Please send s both of the following: yor original passport* any original Home Office docmentation regarding yor or yor relative s stats in the UK and the date it was awarded, and the date it expires if applicable *If yo do not have a passport, we can accept an original UK photo driving licence or original photo identity card as evidence. SWB Undergradate (new) application form (V2) 05/2015 Application form page 11 of 19

12 5 Other grants, brsaries, retainers or spport Have yo applied for or are yo receiving any other grant, brsary, retainer or spport as well as the Social Work Brsary? Do not inclde applications from Stdent Finance England. No Yes Give details. If yo need more space, se part 7 of this application form. Name of organisation yo applied to/are receiving fnding from Name of the grant, brsary, retainer or other spport If yo have applied for or are receiving a retainer, yo mst complete a brsary retainer declaration. Download a copy from or website at: and send it with yor application. Dates of spport From DD / MM / YYYY to DD / MM / YYYY If yo apply for or receive ANY other grant, brsary, retainer or spport after yo sbmit yor application, yo mst inform s in writing. Career development loans do not affect yor application for a brsary, bt if we confirm yor entitlement to a brsary, yo are obliged to let yor loan provider know. SWB Undergradate (new) application form (V2) 05/2015 Application form page 12 of 19

13 6 Employment details 6.1 Will yo be employed in the social care sector dring yor corse? If yo are receiving a retainer only, yo mst complete a brsary retainer declaration. Download a copy from or website at: and send it with yor application. No Go to part 7 Yes Yo mst ask yor line manager to complete the following declaration 6.2 Social care employer s declaration to be completed by yor employer Note to employers By completing this section yo are confirming that the brsary applicant is yor employee and is not receiving any of the following: sponsorship/spport any paid time off to allow them to attend stdies all or part of their tition fees any practice learning opportnity with pay or any other financial spport any other form of spport in order to assist with their social work training The person who completes this declaration mst be the applicant s line manager. If yo have any qestions please contact s on Name of manager Manager s job title Abot the applicant s social care employer Name of social care employer Address Town/city Postcode Contact phone nmber Abot the employee Employee s name Employee s job title Declaration I declare that I am the line manager of the applicant named above and that the applicant is not receiving any spport from the social care organisation shown above. I nderstand that if I give the NHSBSA false, misleading or incomplete information, the applicant named above may be refsed financial spport or any crrent financial spport may be withdrawn reslting in an overpayment for the applicant and I may be prosected. I agree to be contacted by the NHSBSA so they can verify the employment stats and any spport arrangements of the applicant named above. Signatre Date DD / MM / YYYY SWB Undergradate (new) application form (V2) 05/2015 Application form page 13 of 19

14 7 Additional information Use this space if yo need to contine any of yor answers or if there have been any changes which may affect yor brsary application sch as changes to yor corse or the need to repeat all/part of a stdy year. If yo need to contine any of yor answers, please indicate clearly which qestions yo are contining. SWB Undergradate (new) application form (V2) 05/2015 Application form page 14 of 19

15 8 Data protection Data Protection Act 1998 The NHSBSA will se the information that yo have provided for the processing of yor application and for the prevention and detection of frad. We may contact yo to discss yor application and or qality of service to yo by any methods yo have provided. Yor personal data will be deleted from or systems and files no later than seven years after the month in which yor application is processed. We will not disclose yor personal data to any third party nless they have a lawfl right obliging s to do so other than: niversities/colleges local athorities organisations from which yo receive benefits, brsaries, grants or spport the Home Office Stdent Finance England the Stdent Loans Company HM Revene & Cstoms We will not transfer yor personal data otside the Eropean Economic Area. Third party athorisation De to data protection, we are only able to discss yor brsary and other personal details with yo and the organisations listed above. If yo wold like to athorise another person, sch as a parent, to discss yor brsary, please fill in their details below. We will verify their details if the person contacts s. Yo mst sign the applicant s declaration in order for the third party athorisation to take effect and to indicate that yo have soght the person s permission for s to contact them. Third party s first name Third party s last name Third party s date of birth DD / MM / YYYY (This will be sed as a secrity qestion) Relationship between yo and the third party SWB Undergradate (new) application form (V2) 05/2015 Application form page 15 of 19

16 9 Applicant s declaration Read this declaration careflly before signing it. If yo choose not to sign it, we will be nable to process yor application for a Social Work Brsary. I declare that: A B C D E F I will be taking an ndergradate social work corse which is eligible for the Social Work Brsary. I have read and nderstood the application instrctions in fll. By signing this declaration I agree to the following conditions: I will spply any additional information which might reasonably be reqired by the NHSBSA to verify the information I have given on this form. I will inform the NHSBSA immediately in writing of any change in circmstances that might affect my entitlement to financial spport or the NHSBSA s records relating to me. This incldes, bt is not limited to withdrawing, sspending, deferring or interrpting the corse temporarily or permanently for any reason, regardless of whether I intend to retrn changing my stdy pattern from fll-time to part-time, or vice versa being nable to attend the corse for any reason where it exceeds 15 calendar days in total changing the accont I want my payments made to changing address gaining spport from a pblicly fnded body (exclding any of the following: Stdent Finance England, Access to Learning Fnd, government benefit agencies and brsaries from my niversity/college) or my social care employer Failre to inform the NHSBSA may prohibit frther payments and may constitte frad by failing to disclose information which may reslt in criminal prosection. I accept that the NHSBSA will immediately terminate or sspend my fnding if: I withdraw, sspend, defer or interrpt the corse temporarily or permanently for any reason, regardless of whether I intend to retrn I am nable to attend the corse for any reason where it exceeds 15 calendar days in total I take a year or a term ot from stdy the NHSBSA determines at its absolte discretion that it is reasonable for it to do so I gain spport from a pblicly fnded body (exclding any of the following: Stdent Finance England, Access to Learning Fnd, government benefit agencies and brsaries from my niversity/college) or my social care employer The NHSBSA determines at its absolte discretion that I am no longer entitled to financial spport I will pay back to the NHSBSA within 30 days of receiving notification any excess payment, all fees and any other charges in the event of the following circmstances: changing my stdy pattern withdrawing, sspending, deferring or interrpting the corse temporarily or permanently for any reason, regardless of whether I intend to retrn SWB Undergradate (new) application form (V2) 05/2015 Application form page 16 of 19

17 9 Applicant s declaration contined being nable to attend the corse for any reason where it exceeds 15 calendar days in total being overpaid becase I have failed to inform the NHSBSA of a change in my circmstances an NHSBSA administrative error where the NHSBSA at its absolte discretion determines that I have been given financial spport to which I am not entitled, irrespective of any decision made by Stdent Finance England gaining spport from a pblicly fnded body (exclding Stdent Finance England, Access to Learning Fnd, government benefit agencies and brsaries from my niversity/college) or my social care employer Shold I fail to make fll repayment of any amont de or agree an acceptable repayment plan with Social Work Brsaries, the debt may be passed to a debt collection agency. I agree that I will be charged for any additional recovery costs which will be added to the balance otstanding on referral. G I nderstand and accept that the NHSBSA will make recovery of incorrect or fradlent payments and that sspected fradlent applications will be referred for frther investigation to a Conter Frad Specialist, which may reslt in criminal prosection. I nderstand and accept that if I fail to give sfficient notice of any change to my bank or bilding society accont details, or provide incorrect details, the NHSBSA cannot take responsibility for payments made to an incorrect accont, delayed payments or non payment of the brsary. I nderstand and accept that the terms and conditions (inclding rates) of the brsary may change at any time withot notice, and that the scheme is sbject to contined government fnding, which may cease at any time withot notice. I declare that the information I have given on this form is tre, complete and accrate. I nderstand and accept that if I provide the NHSBSA with false or misleading information, financial spport may be refsed or withdrawn and I may be liable to prosection and/or civil proceedings. Applicant s fll name Applicant s signatre Date DD / MM / YYYY SWB Undergradate (new) application form (V2) 05/2015 Application form page 17 of 19

18 10 Posting yor application to Social Work Brsaries Keep a photocopy of all docments sent for yor own records. The NHSBSA cannot take responsibility for applications and evidence lost in the post. Attach a pre-paid, self-addressed Special Delivery envelope if yo are sending spporting docments to s, so we can retrn them to yo secrely and yo can track them once they leave s. If yo do not provide this we will retrn yor docments by second class post. Pay the correct postage and write yor name and address on the back of the envelope to avoid yor mail going astray. Post If yo are sending yor application by Special Delivery, make a note of yor Special Delivery reference nmber. Post this form by Special Delivery to garantee it is delivered to: Social Work Brsaries Bridge Hose 152 Pilgrim Street Newcastle Upon Tyne NE1 6SN Docment list List all of the original docments yo are sending with yor application and fasten yor docments to this page. We will se this list to check that we have received all of yor docments. For official se only SWB Undergradate (new) application form (V2) 05/2015 Application form page 18 of 19

19 11 Checklist Use the checklist below to make sre that yor application is complete. Have yo read the application instrctions that come with this application? Yes No Have yo kept a copy of yor application form and the instrctions for ftre reference? Yes No Have yo answered all of the applicable qestions in each part of this application? Yes No Have yo secrely clipped yor UK passport to this application? Yes No Not applicable Have yo stapled or secrely clipped yor original Stdent Finance England financial notification from the first year of yor corse to this application? Yes No Not applicable Have yo inclded a pre-paid, self-addressed, Special Delivery envelope for the retrn of yor original docments? Yes No Not applicable If applicable, has yor social care employer completed, signed and dated the employer declaration? Yes No Not applicable If applicable, have yo enclosed a completed retainer declaration? Yes No Not applicable Have yo signed and dated the applicant s declaration on page 17? Yes No Are yo sending yor application by Special Delivery post? Yes Make a note of yor Special Delivery reference nmber No SWB Undergradate (new) application form (V2) 05/2015 Application form page 19 of 19

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21 Social Work Brsary Eqal Opportnities Qestionnaire NHS Bsiness Services Athority (NHSBSA) Policy The NHSBSA is committed to eqality of opportnity and to policies and procedres which ensre no applicant receives less or more favorable treatment on the gronds of race, disability, gender, age, religion or belief and sexal orientation. Please provide s with some information abot yorself. It is not complsory to do so, bt yo can be assred that all the information yo do provide will be kept completely confidential. No identifiable information abot yo will be passed on to any other bodies, members of the pblic or press. 1) Which niversity/college are yo stdying at? 2) Which corse are yo ndertaking? 6) Which age grop applies to yo? Tick one box only years years years 3) Which academic year is this application for? Tick one box only. 2015/ /15 Other, please state below 4) Do yo wish to declare information abot yor stats? NB: We will only se this information to monitor the diversity of applicants. It will not be linked to or stored against yor personal details and will not be sed for any other prpose. Yes Go to Qestion 5 No Go to Qestion 12 5) What is yor gender? Tick one box only. Male Female years years 65 years and over 7) What is yor ethnic grop? Tick one box only. A White British Irish Any other backgrond, write below B Asian or Asian British Indian Pakistani Bangladeshi Any other Asian backgrond, write below Transgender/transsexal SWB EO Qestionnaire (V6) 05/2015 Application form page 1 of 2

22 C Mixed White and Black Caribbean White and Black African White and Asian Any other Mixed backgrond, write below D Black or Black British Caribbean African Any other Black backgrond, write below E Chinese or other ethnic grop Chinese Any other, write below 10a) Are yo a disabled person as defined by the Eqality Act 2010? Tick one box only. Yes No The Eqality Act 2010 defines a disabled person as someone who has a physical or mental impairment that has a sbstantial and long-term adverse effect on his or her ability to carry ot normal day to day activities. 10b) If yes, please tick all which apply. Physical impairment Sensory impairment Mental health problem Learning disability/difficlty Long standing illness 8) Which of the following best describes yor sexal orientation? Tick one box only. Lesbian Gay Bisexal Heterosexal 9) What is yor religion or belief? Tick one box only. (Christianity incldes Chrch of Wales, Catholic, Protestant and all other Christian denominations.) No religion Bddhism Christianity Other 11a) Do yo have caring responsibilities for any children or adlts? Yes No 11b) If yes, please tick which apply. Child(ren) Adlt(s) 12) Please enter yor occpation before the start of yor corse. Hindism Islam Jainism Please enter the occpation of the main earner of yor hosehold. Jdaism Sikhism Other, write below 13) Send this form to s with yor completed brsary application. SWB EO Qestionnaire (V6) 05/2015 Application form page 2 of 2