SOUTH CHESHIRE COLLEGE BURSARY SCHEME PRIORITY GROUPS 1-4 APPLICATION FORM

Transcription

1 SOUTH CHESHIRE COLLEGE BURSARY SCHEME PRIORITY GROUPS 1-4 APPLICATION FORM Please complete and return to the Bursary Office in the Library (L003) with your evidence FIRST NAME SURNAME STUDENT ID NUMBER ADDRESS DATE OF BIRTH MOBILE HOME TEL POSTCODE What course are you enrolled on at South Cheshire College? Which year are you in at South Cheshire College? Please tick 1 st Year 2 nd Year 3 rd Year Where were you last year? School or College, please state. Were you in receipt of free school meals in Year 11? YES NO Do you live with adults who are mainly responsible for you? YES NO Please tick here to confirm you are under 19 YES NO I AM LIVING IN CARE (PG1) I AM A CARE LEAVER (PG1) I AM 16-19, LIVING INDEPENDENTLY & CLAIMING INCOME SUPPORT(or UNIVERSAL CREDIT ) (PG1) I AM IN RECEIPT OF ESA (EMPLOYMENT SUPPORT ALLOWANCE)/or UNIVERSAL CREDIT & DLA (DISABILITY LIVING ALLOWANCE) or PIP (PERSONAL INDEPENDACNCE PAYMENTS) (PG1) IT IS ESSENTIAL THAT YOU HAVE YOUR OWN BANK ACCOUNT OPEN SO THAT WE CAN PAY YOU YOUR BURSARY FUNDING! MY FAMILY S GROSS INCOME IS LESS THAN 15,910 A YEAR. (PG2) Please provide bank details on the college BACS form. MY FAMILY S GROSS INCOME IS MORE THAN 15,911 A YEAR (PG 3&4)

2 Please tick which evidence you are providing with your application INCOME SUPPORT /UNIVERSAL CREDIT (PG1) LOCAL AUTHORITY CARE LEAVING SERVICES LETTER (PG1) EMPLOYMENT SUPPORT ALLOWANCE (ESA)/UNIVERSAL CREDIT. DISABILITY LIVING ALLOWANCE (DLA) or PERSONAL INDEPENDENCE PAYMENT (PIP) (PG1) TAX CREDIT AWARD NOTICE (TC602) All pages. (PG2,3 &4) FREE SCHOOL MEAL LETTER YOUNG PEOPLE PROVIDING CARE TO A SICK OR DISABLED REALATIVE within the last 3 months or Current Bank Statement. Written confirmation of your current or previous looked after status/letter from social worker. within the last 3 months *remember to provide DLA/PIP & ESA within the last 3 months or Current Bank Statement *remember to provide DLA/PIP & ESA (Full Tax Credit Award Notice) Not a review Notice Evidence that you were in receipt of free school meals in Year 11. Evidence that the person you are caring for is receiving benefits. (Each case will be assessed individually) RESIDENCY Please tick the box that is appropriate to you A B C D I am a British Citizen and I have lived in the UK for at least 3 years prior to the start of my learning Programme. I have settled status in the UK and have been ordinarily resident in the UK for at least 3 years prior to the start of my learning programme. * I am an EU/EEA national (including Gibraltar) or spouse or civil partner or child of an EU/EEA national and have been ordinarily resident in the EU/EEA for at least 3 years prior to the start of my learning programme. I am been granted Refugee status as a refugee by UK Government, or I am the spouse or civil partner or child of someone with a refugee status, or have been granted Humanitarian Protection, or have EU temporary Protection and live in England. If you have ticked B, C or D you must have provided this information at enrolment to validate your claim. *Settled status means having either indefinite leave to enter or remain (ILE/R) or right of abode.

3 Declaration & Commitment to Learn, Weekly Payment I understand that in order to receive the weekly Meal Allowance PG1/PG2 and monthly payment (PG1 only), I must have 90% attendance in all classes including enrichment, functional/key skills and tutorials and maintain a satisfactory standard of behaviour effort and attitude and comply with the guidelines of the New Bursary Scheme at all times. I understand that if the college is not satisfied with the reasons for absence, the Bursaries Scheme payment will not be made. I understand that this funding covers academic year only. I declare that the statements made on this form are true to the best of my knowledge. I will provide additional information required to support this application. I understand that if I do not provide the correct relevant information then my application will not be accepted. I also agree to contact the college of any changes in writing. I agree to repay the college in full any sums advanced to me if the information I have given is shown to be false or deliberately misleading. By signing below you are agreeing to the above declaration and commitment Signed (Student) Date For College Office use only: Bursary Approved: YES NO Type of Priority 1 Priority 2 Priority 3 Priority 4 Priority 5/6 Bursary: (Please Tick) 1 st Check Signatory Date : 2 nd Check Signatory Date: Additional Information:

4 16-19 BURSARY CLAIM FORM I am on the Bursary Funding and I would like to claim back money towards one of the following college items. (Payable only if attendance is 90% or above) I have already applied for the bursary and I am claiming one of the following bursaries. (Please Tick) PG1-90 monthly award plus 10 weekly Meal Allowance PG2 - ( 10 Weekly Meal Allowance) PG3 PG4 PG5 Please note Bursary is paid 2 weeks in arrears and 2 weeks in advance/arrears and no bursary is paid for college holidays, minimum attendance 90%* You will need to provide receipts for the items otherwise we will be unable to award you with funding. Please note funding will start to be sent out to Bank accounts from November 2013 I am claiming for? CRB Books Equipment Uniform Transport 60% of total cost can be claimed (a further 40% can be claimed from Transport Department based on 90% attendance) Other : College I/D awards, for use in college shop/textile store: Please tick Amount Art related courses - 50 per term Non art courses - 20 per term Printer Credit ( 20 per term) etc College Trips Must be overnight and essential- 50% (up to 500 max) TOTAL Student to sign FOR OFFICE USE ONLY Date Attendance Amount Priority Group Staff to sign

5 BACS TRANSFER FORM Student ID No: Student Name: Please complete all the boxes below If we can pay support directly to you we will do this by paying the money directly into your bank account or someone else s bank account with your permission Please ensure that your account can accept BACS Direct Credits. You can check this with your bank/building society Sorry but we cannot pay into Post Office Card Accounts Bank Name (eg Barclays) Branch Location (eg Market Street,Crewe) Bank Account No: (Usually 8 digits) Sort Code: (Usually 6 digits) Name of Account Holder (eg Mr J Bloggs) Your address for the receipt of Payment Advice Notes: I confirm that I request and authorise South Cheshire College to make any payments into the bank account identified above. Signed: PLEASE RETURN TO THE BURSARY OFFICE IN THE LIBRARY, GROUND FLOOR, ROOM L003. NB ; If you cross out or amend any details on this form you must initial each amendment otherwise we will be unable to process the form. Please check the details carefully; incorrect details can lead to lengthy delays in processing of awards.