BURSARY APPLICATION FORM

Transcription

1 BURSARY APPLICATION FORM Please glue a passport size photo here Please use a black pen Please tick ( ) to indicate your current status: ( ) Presently in Grade 12 ( ) Matriculated but not yet at tertiary ( ) Currently at tertiary: ( ) University ( ) University of Technology (Head & Shoulders) Male ( ) Female ( ) Surname: Other names in full: Please tick ( ) the course you wish to study, or are studying. Indicate your first, second and third choices by writing 1, 2 or 3 in the appropriate spaces: B COMM ( ) ACCOUNTING MAJOR (Affirmative only) ( ) INFORMATION SYSTEMS (Affirmative only) ( ) B COM (INFORMATION SYSTEMS) BSC ( ) CHEMISTRY (Affirmative only) ( ) COMPUTER SCIENCE/SYSTEMS (Affirmative only) ( ) ACTUARIAL SCIENCE ENGINEERING ( ) MINING ( ) MECHANICAL ( ) METALLURGY ( ) CHEMICAL ( ) CIVIL ( ) INDUSTRIAL ( ) QUANTITY SURVEY (Affirmative only) ( ) ELECTRICAL ( ) HEAVY CURRENT ( ) ELECTRONIC ( ) GEOLOGY ( ) MINE SURVEY ( ) MEDICINE ( ) (Specify) COMPANY PREFERENCE: Indicate order of preference 1,2,3 etc. ( ) ANGLO AMERICAN THERMAL COAL ( ) ASA METALS ( ) BHP BILLITON (Indicate Preference): Energy Coal Samancor Northern Cape ( ) COAL OF AFRICA ( ) DE BEERS ( ) DISCOVERY HEALTH (Actuarial Science Only) ( ) NATIONAL SKILLS FUND (All Disciplines Financial Need Criteria) ( ) PETRA DIAMONDS ( ) PPC ( ) VODACOM ( ) WITS GOLD (Females Only Living in a Mining Area) TRUST SCHOLARSHIPS (Proof of financial need required) ( ) ERNEST OPPENHEIMER TRUST (All disciplines including Arts) ( ) GALLAGHER FOUNDATION (Science, Business, Medicine or Teaching degrees studies at University of Cape Town) ( ) FNB FUND BURSARY PROGRAMME (Any BCom/ Engineering) PLEASE RETURN THIS APPLICATION FORM TO THE ADDRESS BELOW: Career Wise (Pty) Ltd PO Box 30632, Braamfontein, 2017 Fax: AndreB@careerwise.co.za Website: Reference Number: PLEASE FILL IN YOUR NAME AND ADDRESS IN THE PANEL BELOW To: Corporate Recruitment and Bursary Services Telephone (011)

2 A. Personal Details 1 Currently studying at the following University / University of Technology 2 Name of the proposed university: (If not yet at University / University of Technology) 3 Name and address of your present or last school: Postal Code: School telephone no: Dialing code: Permanent Home address in full: Postal Code: Home telephone no: Dialing code: Applicants Cell no: Applicants Address: Which address should we use for future correspondence? 4 To which Education Region does your school belong? 5 For purpose of mine visit: Shoe size Overall size 6 Person whom we can telephone to contact you urgently: Name: Telephone no: Dialing code: 7 Name of parent or guardian: FATHER: Occupation: Place of Work: Telephone no: Dialing code: M: Occupation: Place of Work: Telephone no: Dialing code : 8 For interviews please tick ( ) which centre is nearest to you: (it may be possible to interview you at the centre indicated) ( ) Bloemfontein ( ) Cape Town ( ) Durban ( ) Johannesburg ( ) Louis Trichardt ( ) Polokwane ( ) Port Elizabeth ( ) Pretoria ( ) Witbank 9 Place of birth: Date of birth: 10 Age in years this December: Identity Number: Marital Status ( ) Single ( ) Married 11 SA Citizen ( ) YES or ( ) Permanent Resident 12 Do you suffer from a chronic or physical handicap? ( ) YES ( ) NO If yes, please give brief details: 13 Have you been convicted of any crime/crimes? If yes, please state which crimes you have been convicted of: Bursary Schemes Anglo American PLC Anglo Thermal Coal ASA Metals BHP Billiton Coal of Africa De Beers Discovery Health Gallagher Foundation National Skills Fund Optimum Coal Petra Diamonds PPC Wits Gold Thank you for your application. We are pleased to inform you that you will be considered for an interview. Should you be successful you will be informed of the date and venue of this interview by telegram. We regret to inform you that your application was not successful for the following reasons: You are not a South African citizen or permanent resident. Based on our Manpower requirements for this year, we are not offering bursaries to students in your particular discipline or year of study. Your application was received after the closing date for Scholarships 30 May NB: We do not require prelim results. Grade 11 will suffice. Your application has not met our minimum requirements and you were not selected to proceed to the next stage of selection. PO Box BRAAMFONTEIN

3 B. Education 1 Name of Secondary schools attended: NAME OF SCHOOL DATES ATTENDED STANDARDS COMPLETED Only to be completed by current Grade 12 s Please give grade 11 and 12 results: Add additional subjects not listed SUBJECT ENGLISH MATHEMATICS MATHEMATICS 3 MATHEMATICS LITERACY PHYSICAL SCIENCE ACHIEVEMENT LEVEL GRADE 11 GRADE 12 CURRENT POSITION IN CLASS 2 Have you completed Matric? ( ) YES ( ) NO If yes, please complete the following: Name of examination: Year of exam: Final Matriculation Results: SUBJECT HG / SG SYMBOL SUBJECT ACHIEVEMENT LEVEL 3 If you are repeating some of your Matric examinations, please complete the following: Name of centre / school you are attending: Examination date: SUBJECT ACHIEVEMENT LEVEL SUBJECT ACHIEVEMENT LEVEL 3

4 4 Have you undertaken any post-matric studies excluding full-time university? ( ) YES ( ) NO If yes, please give details of course you are studying at present and qualifications (if any) obtained: 5 Are you attending university: ( ) YES ( ) NO If yes, please complete the following: Degree which you hope to obtain: Present year of study: Year which you started your degree: * PLEASE ATTACH YOUR FULL ACADEMIC RECORD TO DATE OR YOUR APPLICATION WILL NOT BE CONSIDERED C. Achievements 1 Give details of all your activities at school and university or in the community, and your role in them: e.g. leadership, sport, cultural, etc. (Please include all details as we use this information for your interview CV for company bursary interviews) SCHOOL / UNIVERSITY / COMMUNITY / ACADEMIC / SPORT / CULTURAL 2 Give details of any activity (academic or otherwise) in which you have done well either at school and/or university, and have maybe achieved awards: (Please attach a separate sheet of paper if this space is not sufficient) 3 Have you had a part-time job? ( ) YES ( ) NO If yes, please describe what you did and where you worked 4

5 D. Career 1 Where did you find out about this bursary/scholarship? ( ) Newspaper / Magazine ( ) Career Talks ( ) Family / friends ( ) School / Teacher ( ) University handbooks ( ) Career exhibitions 2 Have you attended an interview with one of our client companies previously? ( ) YES ( ) NO If yes, which one was it? Which year did you apply? 3 Are you in receipt of any other scholarship, bursary or loan? ( ) YES ( ) NO If yes, what is the name of the award? Does it carry an employment obligation? ( ) YES ( ) NO 4 Give details of working experience since leaving school, if applicable: NAME OF ORGANISATION FROM DATE TO TYPE OF WORK REASON FOR LEAVING 5 Have you ever visited a mine? If so, please give details of where, when and what your impressions were (Only for those applying to mining companies): 6 Write a brief statement setting out clearly why you have chosen this degree and how you intend to use it after graduation: Signed : Date : I declare that to the best of my knowledge all the information on this form is true and correct 5

6 Notes and instructions Please read these notes and instructions carefully before completing this form. Be sure to read every section and that the information you provide is accurate. 1 Application forms that are incomplete will be disregarded. Please ensure that you attach proof of academic results: current matriculants do not need to provide preliminary results final grade 11 will suffice. The earlier you apply the better your chances. 2 Closing date for applications is 31 May. 3 Bursaries will only be allocated for next year. 4 You must supply all the information requested, or explain why you cannot provide it. 5 Applicants applying for bursaries with less than an achievement level of 6 in Mathematics and Science will not be considered for Engineering / Geology and Science degrees and a minimum achievement level of 6 for mathematics is required for accounting degrees. Mathematics literacy will not be accepted. 6 Do not send original documents, please attach copies. 7 Please note that as all our bursaries/scholarships are dependent on our client companies future manpower requirements, we do not always have bursaries for all disciplines. As this situation differs from year to year, we would advise you to re-apply the following year should you be regretted for this reason. 8 A passport size photograph of the applicant must be attached to the top right-hand of the front page. 9 Kindly fill in your name, postal address and postal code in the panel at the bottom of the front page. 10 Please fill in both your parents/guardians occupations so that we can evaluate your financial need level. 11 It is your responsibility to apply for entrance to university and for other options for financial support. We recommend that you apply to at least two universities and for many funding options/bursaries. FOR YOUR INFORMATION WE WISH TO ADVISE YOU THAT OUR SELECTION PROCESS ON ACCEPTANCE OF YOUR APPLICATION CONSISTS OF TWO INTERVIEWS. ANY CHANGE OF ADDRESS OR CONTACT TELEPHONE NUMBER MUST BE FORWARDED TO US AT AndreB@careerwise.co.za OR BY TELEPHONE (011) Career Wise (Pty) Ltd - PO Box 30632, Braamfontein,