BURSARY APPLICATION FORM
INSTRUCTIONS:
1.
Only bursary applications for the study fields below will be considered:
QUALIFICATIONS
(PLEASE TICK THE APPROPRIATE BOX)
Closing Date: 25 September 2015
SCIENCE, AVIATION, ENGINEERING AND BUILT ENVIRONMENT
Civil Engineering
Environmental Engineering (Geo Science)
Mechanical Engineering
Architectural Studies
Electrical Engineering
Aviation/Aerospace Engineering
Aeronautical Engineering
Construction Studies
Town Planning
Building Science
Transport Engineering
Mining Engineering
Chemical Engineering
FINANCE, COMMERCE AND ECONOMIC MANAGEMENT
Public Management Finance
Economics
Financial Management
Econometric
Internal Audit
Accounting / Accounting Sciences
Actuary Sciences
LAW & HUMANITIES
Law
Community Development
Clinical Psychology/Industrial Psychology
Political Science
Youth Development
International Relations
TRANSPORT, MANAGEMENT & ADMINISTRATION
Business Administration/
Entrepreneurship
Transport & Logistics
Tourism Management
Real Estate/ Property Management
Public Administration
Airport Planning
HEALTH AND ENVIRONMENT MANAGEMENT
Environmental Health Management
Disaster Management
Nursing
Water and Sanitation
INFORMATION TECHNOLOGY
Computer Science
Information & Communications
Technology
System Engineering
Software Engineering
VOCATIONAL PROGRAMMES
Masonry
Carpentry
Plumbing
Industrial Welding
2. Answer all the questions on this form fully and correctly.
INCOMPLETE AND LATE APPLICATIONS WILL NOT BE CONSIDERED.
You are eligible to apply for a bursary if you:


Are a Citizen / permanent resident of South Africa
Reside in Ekurhuleni
Pursue undergraduate studies
3. Attach the following documentation:
 A detailed monthly salary / wage slip must be attached if parents/parent are/is working.
 Certified copies of Identity Document, Municipal Services Statement Account, academic
statement (half yearly/preliminary results), brochure of school or registration letter should
also be attached.
 Attach certified copies of death certificates if parents are deceased
 Proof that parents/guardians are indigent
 Give any other relevant information.
4.
This application must be sworn in front of a Commissioner of Oaths if parents / parent are
unemployed.
5.
Return the application to local service centers where it was collected.
6.
Bursaries are determined on financial need and academic achievements. If students are
not advised of the results of applications within 2 months from the date of advertising of the
bursary, they should consider the application as having been unsuccessful.
7.
The current bursary holders need not reapply as their contracts may automatically be
renewed for the ensuing year.
8.
The amount of the bursary allocated is determined on an individual basis and may vary
according to committee decisions made. If granted, this bursary will not be paid to you, but
will be credited to your student account with the Academic institution.
PROPOSED FIELD
OF STUDY
NATIONAL
DIPLOMA
DEGREE
NATIONAL
CERTIFICATE
1.1
1.2
1.3
1.4
Present academic year (i.e. GR 12, 1st
year)
Name of University/Technikon/ Technical
College
Choice of major subjects
Tuition
1.7
Total amount required
1.8
When will studies be completed?
1.9
Duration of course
1.10
Have you applied for any other bursary
1.11
If yes, where, and what was the outcome
1.5. Books
2. PERSONAL PARTICULARS
2.1
Surname
2.2
Names
2.3
Race
2.4
Disability
Yes
No
If Yes Specify:
2.5
Child of Employee
Yes
No
If Yes
2.6
Identity Number
(Attach Certified
Copy)
2.7
Male
2.8
2.9
Please Attach Pay Slip
Residential address
Ward
No.(Compulsory)
Contact
Home
Numbers
Municipal services account number
(Attach account statement)
Female
Postal address
EMAIL
Work
(parents)
Cell
2.10
Town
3. SCHOOL PARTICULARS
3.1
Name of last school attended
3.2
Highest school standard passed
3.4
3.3
Year
completed
Subjects passed
Subject
Symbol/Level
3.5
Do you comply with all requirements for University exemption?
3.6
Describe all special academic achievements obtained
Grade
YES
NO
4.
PARTICULARS OF PARENT/LEGAL GUARDIAN
(Ignore what is not applicable)
4.1
Full names of Parent/Legal guardian
4.2
Occupation of Parent/Legal guardian
4.3
Employer of Parent/Legal guardian
4.4
Salary of Parent/Legal guardian
4.5
Residential address of Parent/Legal
guardian
4.6
Contact
Numbers
5.
Gross
Home
R
Net
Work
R
Cell
DECLARATION
5.1
I declare that the particulars are to the best of my knowledge true and correct.
`
SIGNATURE OF APPLICANT
DATE
SIGNATURE OF PARENT/LEGAL GUARDIAN
DATE
Office Use Only
Checklist
Certified ID copy
Certified Municipal account
(Proof of Ekurhuleni residence)
Certified Results
Certified Registration Letter
Certified Pay slip: Father
Certified Pay slip: Mother
Certified Death Certificate: Father
Certified Death Certificate: Mother
Affidavit unemployment: Father
Affidavit unemployment: Mother
Outstanding Study Fees
Outstanding Municipal Accounts
If Indigent, Proof attached
Office Use Only
Checked & Shortlisted By
Name
Signature