BURSARY APPLICATION FORM

Transcription

1 BURSARY APPLICATION FORM Complete applications received by Wednesday 22 nd August 2018 are guaranteed payment at the beginning of September. Applications received during September will be acknowledged but due to the pressures of enrolment may not be processed immediately. Please use block capitals to complete this form. Please make sure that all relevant sections are completed. Incomplete forms will be acknowledged but no further action will be taken until all outstanding information is received. This could result in a delay to any funding to which you may be eligible. To avoid your application being delayed or rejected please provide official evidence of household income and current Council Tax Bill. Photocopies of original documents are required, we will not be able to make copies for you. We are unable to return documents Section 1 Personal Details (to be completed by Student) Surname: Forename: DoB: Age on 31 August 2018: Gender: M/F Address: *Parents mobile number *Parents address *Home phone number *contact numbers must be provided Postcode: Postcode: Have you lived in the UK for the 3 years prior to the course start date? Yes/No How long have you lived at this address? Years Months Are you an asylum seeker? Yes/No If YES please enter your 9 digit National Asylum Seeker number here Or, include a copy of your letter from the National Asylum Support Service (NASS)

2 Section 2 Status (to be completed by Student) Please tick the boxes that apply to you, please provide evidence of benefit, or written confirmation from your local authority of looked after status. If not applicable please go to Section 3 I am living under the care of the Local Authority I have recently left the care of the Local Authority Students in care or a care leaver must provide the following to support their application Written confirmation of current or previous looked after status from the relevant local authority. Or an from the relevant local authority to jane@aquinas.ac.uk I receive Income Support or Universal Credit in my own right * please see bursary guidelines on the Aquinas College website I receive Disability Living Allowance or Personal Independence Payment as well as Employment Support Allowance or Universal Credit in my own right Students in receipt of qualifying benefits must provide the following to support their application a letter from DWP confirming which benefit the student is entitled to. The letter should also confirm the young person can be in further education Parents should be aware that they will not be able to continue to claim Child Benefit if the young persons claim for ESA succeeds Section 3 Bank/Building Society details Name of account holder: Bank or Building Society account must be in the student s name. Please enclose a copy of an account statement/letter or form from your bank that shows the students name, sort code, account number and home address. ** Please supply the roll or reference number for building society accounts. We are unable to process payments without this information

3 Section 4A Family Details Who do you live with? (please tick all that apply) Mother Father Mother s partner Father s partner Grandparent(s) Foster parents Independently Other: Section 4B How many brothers/sisters under the age of 18 and unwaged) live with you How many brothers/sisters over the age of 18 live with you Are you are registered young carer? Section 5 Meals and Transport Will you use public transport to get to college: Bus Train Other I would like to apply for free school meals To be eligible for free school meals you must be: Aged16-18 on 31 st August 2018 and enrolled in further education funded by the EFA Be in receipt of, or have parents who are in receipt of, one or more of the following benefits: Income support Income based Jobseekers Allowance Income related Employment Support Allowance (ESA) Support under part VI of the Immigration and Asylum Act 1999 The guarantee element of the State Pension Credit Child Tax Credit (but not entitled to Working Tax Credit and yearly income does not exceed as assessed by HMRC) Working Tax Credit run-on (paid for 4 weeks after you stop qualifying for WTC) Universal Credit with net earnings not exceeding the equivalent of 7400 pa If self-employed and claiming free school meals please complete the self-employment declaration form at the end of the application form If your application is successful please tell us how the bursary award would assist you: *If there are available funds college may be able to pay the travel costs for a university visit, an apprenticeship interview or job interview.

4 Section 6 Household Income - Completed by Parent(s)/Carer(s) *Failure to submit all relevant documentation will delay your application. Please provide only photocopies Where income is NULL parents/carers must be in receipt of one or more of the following benefits: Income Support, income based Job Seekers Allowance, Income related Employment Support Allowance (ESA), Support under part VI of the Immigration and Asylum Act 1999, the guarantee element of the State Pension, Child Tax Credit (but not entitled to Working Tax Credit and yearly income does not exceed 16190), Working Tax Credit run on paid for four weeks after you stop qualifying for Working Tax Credit, during the initial rollout of the benefit Universal Credit. Parents/Carers must apply for the benefits they are entitled to. The bursary award will not replace any benefits for which you are eligible. Household Income Parent/Carer 1 Parent/Carer 2 Employment Income please provide P60 to April 2018 Self-Employment Income please provide current SA302 and dividends Income from savings, shares, investments, trusts, dividends etc (please provide official evidence) Pension Income Pension Credit M1000 award notice Rental Income Tax Credit (please provide official evidence) The full working/child tax credit document for The tax credits review document is not sufficient Universal Credit If in receipt of Universal Credit, please indicate which benefit it has replaced. Income Support Personal Independence Payment Job Seekers Allowance Employment Support Allowance

5 Disability Living Allowance Carers Allowance Council Tax Bill Year 2018/19 ( Applications will not be processed without a photocopy of a current council tax bill) Other Benefits e.g. housing benefit. Please include documentation Any other household income, please provide evidence

6 STUDENT DECLARATIONS to be completed by all applicants This section must be completed by the student applying for a Bursary award. I declare that all the answers given in this form are true. I have read the Bursary Agreement and understand and accept my obligations. I understand that if I give false information or withhold information my Bursary application will be cancelled and, if necessary, action will be taken to recover any money paid to me. I understand that if I leave college, I will not be eligible for any further payments. I understand that relevant information may be passed on to third parties within the Local Authority. I consent to the college providing details of the progress of my application and award to the person named as Parent/Carer in this application form. SIGNED: Date: PRINT NAME: PARENT/CARER DECLARATIONS to be completed by all parent/carers (not applicable for independent students) I/We declare that to the best of my/our knowledge and belief all the information given, in connection with this application is full and correct in every respect. I/We understand that if my/our child does not keep to the conditions of their Bursary Agreement, payments may be withheld I/We understand that if my/our child leaves college, he/she will not be entitled to any further payments. PARENT/CARER 1 PRINT NAME: SIGNED: Date: PARENT/CARER 2 PRINT NAME: SIGNED: Date:

7 Bursary Contract Students are required to attend: 1. All timetabled lessons. 2. Assemblies, registration sessions, tutorial sessions and Ethics. 3. For payment to be guaranteed, you must ensure that your attendance record, from the previous week is correct no later than 3pm Monday afternoon. You can check your attendance on MyAquinas. Failure to do so and amend any incorrect absences will lead to non-payment of your bursary. Payments will not be back dated. 4. The accuracy of your attendance record is your responsibility you must check it regularly. Absences 1. Bursary payments are made to help you cover the cost of attending college. 2. If you are absent it is possible you will not be paid. 3. If your absences are authorised your Bursary payment could still be made even if you are away for a short period. If the absence is expected your Parent/Carer must notify college in advance. If it is unexpected your Parent/Care must notify college on the day of each absence. (You may be allowed up to 3 authorised absences in a half term before your payment will be affected). 4. If your absences are unauthorised your Bursary will be stopped for the week in which the unauthorised absence occurs. 5. If you miss a whole week you will not be paid under any circumstances. 6. If your unauthorised absences build up to 10 days in a year, it is possible you will no longer be eligible for payments. 7. Make sure you are aware of the content of the attendance policy. Punctuality You must be punctual to college and to lessons. 3 lateness marks in a half term will lead to non-payment. Behaviour and Standard of Work Your payments may be withheld at the colleges discretion if your behaviour or standard of work is problematic. Failure to adhere to the terms of the Colleges Learning Agreement may also lead to payment being with held. Time Limit for Review of decision Students may appeal against the refusal of a weekly payment, and will need to supply any additional information to support the appeal within 1 week of the week in question. Student name (PRINT)... Student name (SIGN). Date.

8

9 Self-employment declaration form Free meals in further education (FMFE) self-employment eligibility declaration form This form is for completion by self-employed parents claiming FMFEeligibility for the student. Parents should provide evidence demonstrating that they are in receipt of Universal Credit (such as their Universal Credit award letter), that they are self-employed (such as their company registration form or tax return) and that their net earned income has not exceeded either over the previous month, 1, over the previous two months, or 1,850 over the previous three months. This evidence should take the form of monthly accounts, like those provided on a monthly basis to DWP, supported by actual receipts where requested. Universal Credit eligibility I have attached evidence proving that I am in receipt of Universal Credit Y/N Self-employment status I have provided evidence proving that I am self-employed Y/N Earnings I have provided evidence that my net earnings over the period / / - / / were Y/N (If net earnings for the latest month exceed , fill out details for the latest two months. If net earnings for the latest two months exceed 1,233.34, fill out details for the latest three months) Declaration I certify that the information I have provided is complete and correct and understand that it is fraudulent to give false information. I agree that the information provided with this form can be used to check the student s for FMFE. Printed Name: Signature: Date: