Hardship Fund Grant. Single Students. Directorate of Student & Academic Services IMPORTANT



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Directorate of Student & Academic Services Hardship Fund Grant IMPORTANT Single Students 1) Please ensure that you read the guidance booklet before filling in your application form 2) Please submit PHOTOCOPIES only of your supporting documents 3) Your application WILL NOT be considered complete if you are missing any of the documents required and will not be assessed. Please refer to the document checklist for a list of these documents. It is YOUR responsibility to check that you have submitted the correct documents 4) If the assessment team needs further documents, you will have 10 working days from the date requested to submit these copies Please print your application form once completed and submit this with your supporting documents to the Hub in Richmond Building or send by post to: Student Financial Support Team The Hub, University of Bradford Richmond Road, Bradford, BD7 1DP UOB GRANT

Hardship Fund Grant Checklist Document Current Student Financial Breakdown from Student Finance England, Wales, Ireland or Student Awards Agency for Scotland. (UG students only) (We do not need your Payment Timetable or the University or College Payment Advice) Current NHS Bursaries Notification Letter. (NHS students only) Tick Social Work Bursary (Social Work students only) Career Development Loan/ other funding (Postgraduate & 2nd degree students) Last 3 months consecutive bank statements. Please put copies of all accounts in your name in statement order. Please explain all cash transactions and all other transactions over 50 Evidence of rent/ mortgage Income from other sources i.e. wage slips Other (please give details) Other (please give details) 1 UOB GRANT

Part 1 Your Personal Details Student UB Number: Surname: Accommodation: Where do you live in term-time (please tick relevant box) Alone With parents/relatives In shared accommodation Forename(s): Correspondence address: Do you live: (please tick relevant box) In council-owned/housing association property In purpose built student accommodation In private, rented accommodation House Owner/mortgaged property Other please specify below Your age in years: Contact number: University email: @bradford.ac.uk This is the only email address we will use to contact you about your application unless there is a prior arrangement. For security, any queries you have about your application must be by email and sent from your student account. Part 2 Your Course Details Course Title: (e.g. BSc Biomedical Sciences) Faculty: (e.g. Faculty of Life Sciences) Are you: Undergraduate Postgraduate Full-time Part-time Date course started: (Month & Year) Length of course: (Years) Year of course: (e.g. 2nd) Please tick if any of the following apply: A repeat year A placement year A final year A foundation year UOB GRANT 2

Part 3 Disabilities/Special Medical Needs Do you have a disability or chronic medical condition? Yes No If No, please go to Part 4 If Yes: Please give details of your disability or chronic illness: Are you registered with Disability Services? Yes No Have you applied for the Disabled Students Allowance (DSA)? Yes No Have you applied for any financial assistance towards any special equipment/materials not covered by DSA or for assistance towards the cost of a diagnostic test (e.g. dyslexic students)? Yes No Part 4 Income Income Divide your SFE funding by 39. If you are studying Nursing/Midwifery, divide your NHS funding by 52 Evidence Required (Photocopies only) Per Year Per Week SFE Maintenance Grant Student Finance Financial Breakdown SFE Maintenance Loan Student Finance Financial Breakdown NHS Bursary NHS Awards Letter Social Work Bursary NHS Awards Letter University Bursary (pre 2012) No evidence required AAB/ABB Scholarship No evidence required National Scholarship Programme (excluding fee reduction) No evidence required Scholarships/Trusts/Other Grants Awards Letter Parental Contribution Letter from parent Disabled Students Allowance Notification from Student Finance Disability Benefits Awards letter Career Development Loan Letter from the bank Other (Please Specify) Relevant Evidence 3 UOB GRANT

Part 5 Expenditure Expenditure Evidence Required (Photocopies only) Per Year Per Week Rent/mortgage Tenancy Agreement/ Mortgage Statement Travel Costs No evidence required Medication Explanation in personal statement CSA Maintenance paid by you Proof of payment Do you have a car? Yes No Do you have any loans or finance outstanding on the car? Yes No Part 6 Priority Debt Total Owed Minimum Weekly Payment Have you made any special arrangements? Rent/mortgage arrears Secured Loans Council Tax arrears Gas and electricity arrears Part 7 Work Do you have a part-time job? Yes No Are you registered with the Career Development Service? Yes No Do you work in the summer vacation? Yes No If no, please state the reason below: UOB GRANT 4

Part 8 Post-graduate Students Only How do you intend to fund your living costs during your post-graduate course? If you are self-funding, how do you intend to meet the cost of your tuition fees? Part 9 Supporting Statement Please state below why you are in financial difficulty, making sure you answer the questions in as much detail as possible If you are filling this application out on paper please attach a typed sheet. We will not accept a handwritten statement Why do you believe your situation to be exceptional and to merit addition support? Please continue on a separate sheet if necessary. Please ensure this is typed 5 UOB GRANT

What measures have you taken to help yourself? Please continue on a separate sheet if necessary. Please ensure this is typed UOB GRANT 6

Part 10 All Bank Accounts Please give details below for every account you hold. This means all accounts including savings and ISA accounts. Name of Bank Type of Account e.g. Student/ Current/Savings Account Number Sort Code Current Balance Maximum Overdraft Facility Please provide copies of the last full 3 months bank statements for ALL accounts held. You will need to explain all cash transactions and all other transactions over 50 Part 11 Bank Account Details for Awards Made Any award made from the University of Bradford Hardship Fund will be paid into this bank account by BACS. Please make sure that the information you provide is clear and correct as it can be difficult to retrieve payments that have been paid into the incorrect account. Sort Code - - Account Number Name of Bank 7 UOB GRANT

Part 12 Declarations I certify that to the best of my knowledge, I meet the following conditions: (please tick the relevant box) I am a UK national/british citizen I have been recognized by the UK Government as a Refugee I have been granted Humanitarian Protection (HP) by the Home Office I am an EEA or Swiss Migrant Worker or the family member of an EEA or Swiss Migrant Worker (please tick if you in-tend to continue working whilst studying) 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 I am the child of a Swiss national I am the child of a Turkish worker I am settled* within the United Kingdom (UK) (i.e. I have the Right of Abode in the UK or have been awarded Indefinite Leave to Remain * settled on the first day of the first academic year of your course. PLUS (please tick the relevant box) I was ordinarily resident** in England, Scotland, Wales or Northern Ireland on the first day of the first academic year of the course*** I was ordinarily resident in the EEA, Switzerland or Turkey for 3 years immediately before the first day of the first academic year of the course I have been recognised by the Government as a Refugee and have full refugee status ** Ordinarily resident is interpreted to mean habitual and normal residence from choice and for a settled purpose throughout the prescribed period, apart from temporary or occasional absences. Such residence must also be lawful that is, not in breach of any leave to remain in the UK. (Persons awarded refugee status or humanitarian protection must have been ordinarily resident in the UK from the date this status was granted.) ***None of this time was wholly or mainly for the purpose of receiving full-time education, or if it was, I was resident in the EEA immediately prior to this 3 year period UOB GRANT 8

Part 12 Declarations Please tick all of the following I confirm that I am registered and in attendance on the course described in this form I confirm that I am not living with a spouse/partner I understand that giving false information will automatically disqualify my application and will also lead to disciplinary procedures resulting in possible expulsion from the university I understand that any information given in this form will be passed to any other organization if required for the detection of fraud I undertake to repay, in full, any amount of payment made to me from the University Hardship Fund if the information is shown to be false I agree that all or part of any award may be paid directly to a third party if necessary I confirm that I have provided all the relevant information and attached the necessary documentation I understand that the university may make any enquiries deemed appropriate in connection with this application I understand that in the majority of circumstances I will not be entitled to any further loans from the Hardship Fund if I have in excess of 1000 outstanding from the fund I declare that the information I have given on this form is correct and complete to the best of my knowledge Please print this application once completed and sign and date below: Your name (Capitals): Your Signature: Date: Confidentiality Applications are seen only by the committee and the Hardship Fund Assessment team. It may be necessary for additional supporting information to be sought from other University staff in order for the Committee staff to reach a decision. Data Protection Act 1998 The University of Bradford is a data controller in terms of the 1998n legislation. The student finance office follows University policy in matters of data protection. The data requested in this form is covered by the notification provided by the University under the data protection act, Personal data will be used solely in the department for statistical purposes and electronic records keeping. The data will not be passed to any other 3rd party without your consent, except when the University is required to do so by law. Any formal enquiries concerning the use of data noted here should be addressed to the Student Financial Support Manager. 9 UOB GRANT

FOR OFFICE USE ONLY Family Name: First Name: UB Number: HESA No.: Assessed by: Percentage: 100% 75% Comments: Date: Grant Amount: Loan Amount: Date to Repay: Unsuccessful Reason: Standard Transfer BACs Cash Non Standard Loan Amount Method Date Paid to: Paid to: Paid to: Paid to: Final Year Payment Yes No Low Income Family Yes No Mature Student with pre-existing debt Yes No Transfer Checklist Cheques issued TFR tab Input repayment via TFR on Loans Spreadsheet Mark Loan form as repaid Mark repayment on the back sheet Payment Checklist Database Cheques Issued BACs/CHAPs/Cash Front Sheet & D/E on front of application form Letter Payment request Book Copy of payment request with Class no. UOB GRANT 10