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Bursary Application Form
( for UNEMPLOYED candidates only)
1. Please complete the application form in black ink.
2. Complete one form per learner
3. Originally certified copy of your ID Document
4. Applications are open to candidate within the qualifying age (18-35).
5. If you are in your first year at an institution, include a certified copy of your Grade 12
examination results and current academic results.
6. Attach proof of registration for those beyond first year of study ( applicable for continuing
students only)
7. Attach highest grade and qualification achieved including result.
8. Proof of Income/ Affidavit (for unemployed), and certified ID copies of parent/guardian.
9. A motivational letter written by yourself, the applicant, stating why you should be considered for
a bursary and explaining why you require funding via the bursary.
Attach certified copies of the required documents to the application form. Do NOT submit
them separately. Do NOT send original documents.
Section A : Particulars Learner
Surname:
Maiden surname (if applicable):
First name:
Title (Mr. Mrs. Ms.):
Date of birth:
Identity Document number:
Race :
African
Indian
Coloured
White
Other (Specify)___________________
Disability
(underline
nature of
disability
applicable)
Gender:
the
the
if
01
02
03
04
05
06
07
09
Sight (even with glasses)
Hearing (even with a hearing aid)
Communication (talking, listening)
Physical (moving, standing, grasping)
Intellectual (difficulties in learning); retardation
Emotional (behavioural or psychological)
Multiple
Disabled but unspecified
Male
Female
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Citizen Status:
South Africa
Dual (SA Plus Other)
Other (Specify)___________________
Physical address
Postal address
Province :
Gauteng
Mpumalanga
Free State
Western Cape
North West
Northern Cape
Kwa-Zulu Natal
Limpopo
Municipality :
Eastern Cape
City:
Learner Residential Area :
Urban
Tel number
Rural
Fax number:
Cell number
Email address
Highest level qualification completed :
(Highest level school qualification completed e.g. grade 10 ,11,12):
Section B :Particulars Of Next Of Kin
Surname:
First name:
Title:
Relationship:
Tel number:
Cell number:
Address:
Section C :Particulars Of Study
Institution Name:
Campus:
Student Number:( if applicable)
Name of Qualification:
Qualification ID number:
NQF level:
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Specialisation:
Year of studies (e.g. 1st year,2nd year):
Start Date:
End Date:
Bursary Amount: (per annum)
R
Name of Institution
Private  Public 
FET  HET 
Physical address
Tel number
Fax number:
Email address
Learner Declaration
(Please note that the guardian signature is required if the learner is under 18 years)
1. I declare to the best of my knowledge that all information on this form is true and correct and I
understand that if it is not, I may be eliminated from consideration in the selection process. If
after being granted a bursary, any falsehoods or omissions are discovered in my application, I
understand that my bursary grant may be terminated.
2. I undertake to avail myself for participation in all structured learning, practical workplace
experience and assessment activities required by the bursary scheme.
3. I indemnify the LGSETA and its officials against any claim for illness or accidental injury sustained
by me in the workplace and during operations in the attainment of the bursary scheme
objectives.
4. I Authorisation the LGSETA to deal directly with the Institute on my behalf and receive copies of
my progress reports quarterly and results.
Name and Surname of learner
Signature of learner :
Date:
(Only applicable if the learner is a minor)
Name and Surname of parent or guardian
Parent of guardian’s signature:
Date:
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NOTES AND INSTRUCTIONS FOR COMPLETION
Read these notes carefully before completing the application form. Make sure that you read every
section and that the information you provide is accurate.
1. INCOMPLETE FORMS WILL NOT BE ACCEPTED (this includes forms with missing documents)
2. The LGSETA does not take responsibility and will not be held liable for any forms which were
undelivered or missing.
3. Student who are granted a bursary from another organisation/institution are obliged to
inform the LGSETA. The LGSETA have the right to withdraw funding awarded if the student
receives a bursary elsewhere.
4. The LGSETA bursary is annual award, therefore students will be required to re-apply annually to
LGSETA.
5. Non South African students will not be considered.
6. The student must meet the entry requirements for the programme as required by the HET or
TVET Institution. The qualification must be accredited on the NQF/N Levels.
7. The LGSETA will only fund a course which falls within the scarce and critical skills areas in Local
Government see Table 1 and 2 below:
Table 1:
OFO Code
LGSETA Scarce and Critical Skills
Occupation
121101
121104
121301
121905
132301
213306
214201
214202
216401
241101
242207
242211
311201
311203
313201
312301
325802
331301
341110
341201
351302
541101
Chief Financial Officer
Internal Audit Manager
Policy and Planning Manager
Project Manager
Construction Project Manager
Water Quality Technician
Civil Engineer
Civil Engineering Technologist
Urban and Regional Planner
Accountant (General)
Compliance Officer (Risk Officer)
Internal Auditor
Civil Engineering Technician
Town Planning Technician
Water Plant Operator
Building Construction Supervisor
Paramedic
Finance Clerk/Administrator
Legal Advisor/Officer
Community Development Worker
GIS Specialist
Fire Fighter
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642601
671101
Plumber (General)
Electrician (General)
Table 2
According to Chapter 14 – Schedule 4B of the South African Constitution, the general provisions of
local government are as follows:
1
Air pollution
2
Building regulations
3
Child care facilities
4
Electricity and gas reticulation
5
Firefighting services
6
Local tourism
7
Municipal airports
8
Municipal planning
9
Municipal health services
10
Municipal public transport
11
Municipal public works only in respect of the needs of municipalities in the discharge of their
responsibilities to administer functions specifically assigned to them under this Constitutional or
any other law
12
Pontoons, ferries, jetties, piers and harbours, excluding the regulation of international and
national shipping and matters related thereto
13
Storm water management systems in built-up areas
14
Trading regulations
15
Water and sanitation services limited to potable water supply systems and domestic waste-water
and sewage disposal systems
Completed application forms with the attachments should be submitted to:
LGSETA, 47 Van Buuren Road, Bedfordview, 2007 or emailed to [email protected].
All submissions MUST be clearly marked for the attention of LGSETA Bursaries.
Closing date for applications is 31 May 2016