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19+ Bursary
19+ Bursary
admin
2020-07-17T11:28:07+00:00
Personal Details
Student ID Number
*
Date Of Birth
*
Day
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Year
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1920
Forename
*
Surname
*
Email
*
Mobile Number
*
Residency
Are you a UK national who has been resident in the UK for at least 3 years?
*
Yes
No
Are you an Asylum Seeker?
*
No
Yes
Household Situation
Please tick all that apply
*
I live with my parent(s)/carer
I live with a partner
I am a single parent
I live alone
Special Circumstances
Please tick all that apply
Health Issues
Learning Difficulties
On Probation (Ex-Offender)
Ex-Military Personnel
I have an Educational Health Care Plan (EHCP)
Yes
No
Travel
How do you intend to travel to College?
*
Bus
Train
Walk
Income Details
Is the household in receipt of Tax Credits or Universal Credit?
*
No
Yes
Please tick all that apply:
*
Tax Credits
Universal Credit
Tax Credits
Please enter your total income
Evidence
Please Provide all pages of your 2022/23 Award Notice
Drop files here or
Select files
Accepted file types: jpg, png, pdf, Max. file size: 25 MB.
Universal Credit
Please enter your total income
Evidence
Evidence of UC statements for last 3 months
Drop files here or
Select files
Accepted file types: jpg, png, pdf, Max. file size: 25 MB.
Are any members of the household in employment?
*
No
Yes
Please tick all that apply:
*
A wage or salary from an employer
Payment from Self-Employment
A wage or salary from an employer
Please enter your total income
Evidence
Three most recent payslips per person or most recent self-assessment evidence
Drop files here or
Select files
Accepted file types: jpg, png, pdf, Max. file size: 25 MB.
Payment from Self-Employment
Please enter your total income
Evidence
Three most recent payslips per person or most recent self-assessment evidence
Drop files here or
Select files
Accepted file types: jpg, png, pdf, Max. file size: 25 MB.
Are any members of the household (including yourself) in receipt of:
Income Support
Employment & Support Allowance
Jobseekers Allowance (Income Based)
Pension Credit (Guaranteed Element)
DLA/Personal Independence Payment
Income Support
Please enter your total income
Evidence
Please Provide your latest Award Notice
Drop files here or
Select files
Accepted file types: jpg, png, pdf, Max. file size: 25 MB.
Employment & Support Allowance
Please enter your total income
Evidence
Please Provide your latest Award Notice
Drop files here or
Select files
Accepted file types: jpg, png, pdf, Max. file size: 25 MB.
Jobseekers Allowance (Income Based)
Please enter your total income
Evidence
Please Provide your latest Award Notice
Drop files here or
Select files
Accepted file types: jpg, png, pdf, Max. file size: 25 MB.
Pension Credit (Guaranteed Element)
Please enter your total income
Evidence
Please Provide your latest Award Notice
Drop files here or
Select files
Accepted file types: jpg, png, pdf, Max. file size: 25 MB.
DLA/Personal Independence Payment
Please enter your total income
Evidence
Please Provide your latest Award Notice
Drop files here or
Select files
Accepted file types: jpg, png, pdf, Max. file size: 25 MB.
Declaration
Terms & Conditions
I confirm that the information given on this form and accompanying evidence is truthful and correct to the best of my knowledge. No false or incomplete information has been submitted and I have made the College aware of any part of my own or my household income. I understand that the College has the right to make an independent check of any evidence submitted and as such, action may be taken to recover funds and stop future payments in the event of any information I have given being proven to be incorrect or false. I agree that my attendance will remain at 90% or above overall (unless I experience exceptional circumstances) and that my conduct and progress on the course will be in line with College Policy. Where my attendance, conduct and/or progress is not up to this standard then I understand that the College may stop my payments, and reclaim any kit or uniform provided under the bursary scheme.
Consent
*
I agree to the terms & conditions above.
I agree for the College to discuss my financial payments with my parents/carers/guardians or partner
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