Bursary Form

Your Details

Student ID (if known)

Email *

Surname *

First Name *

Date of Birth *

Telephone/Mobile *

Age on 31 August 2022 *

Were you born in the UK or EU? *

Yes

No

Address *

Country

City

State

Zip code

Course *

Type *

Reason for your application *

Please tell us about your household circumstances that will assist us to make a decision about your application. Please tell us if you have caring responsibilities for a member of your household.

Are you an Asylum Seeker? *

Yes

No

You will need to provide home office, NASS, IND or ARC card, along with your parent’s evidence.

Qualifying Evidence

Are you / were you ever in the care system? *

Yes

No

Provide written confirmation of current or previous looked after status from the relavent local authority. The evidence can be a letter or email clearly from the local authority dated within the past 3 months.

Are you a young person in receipt of Universal Credit or Income Support in your own right because you are financially supporting yourself, or anyone who is dependant on you and living with you such as a child or a partner? *

Yes

No

Provide an Income Support letter dated within one year or 3 most recent Universal Credit statements UC statements can be printed or screenshots can be provided. If you are in receipt of Universal Credit- please also provide only ONE of the following documents: * A tenancy agreement in your name * A Child Benefit letter * Children’s birth certificate * A utility bill in your name

Are you a young person in receipt of Disability Living Allowance (DLA) or Personal Independence Payments (PIP) in your own right as well as Employment and Support Allowance (ESA) or Universal Credit (UC) in your own right? *

Yes

No

Provide evidence of DLA or PIP payment letter and 3 most recent Universal Credit statements. UC statements can be printed or screenshots can be provided Along with ONE of the following to show independent living: * A tenancy agreement in your name * A utility bill in your name

Do your parent(s)/guardian(s) receive Tax Credits? *

Yes

No

Provide all pages of your 2022/23 Tax Credit Award Notice, If this is not available we can accept a Tax Credit annual review (from previous April) with 3 months bank statements, with a child benefit letter dated within one year

Do your parent(s)/guardian(s) receive pension credit payments with the guarantee element, which is the only source of household income? *

Yes

No

Provide pension payment letter dated within one year, plus a child benefit letter dated within the last year

Do your parent(s) receive Universal Credit? *

Yes

No

Provide 3 most recent Universal Credit statements, plus a child benefit letter dated within one year UC statements can be printed or screenshots can be provided

Do your parent(s)/guardian(s) receive any of the following: *

Income Support
Jobseekers Allowance
Employment Support Allowance
Carers Allowance
Housing Benefit and/or Council Tax Benefit

Yes

No

*IS or JS-Provide an award letter, plus a child benefit letter dated within one year *ESA or CA- Provide an award letter, plus a child benefit letter dated within one year, plus 3 most recent pay slips *Housing Benefit and/or Council Tax Benefit – Provide an award letter dated within one year

Do your parent(s)/guanrdian(s) have a household income from earnings of under £30,000 before tax. *

Yes

No

Provide 3 most recent pay slips for all parents/guardians in the household, plus a child benefit letter dated within one year. If either parent/guardian is self-employed - a statement of accounts for the 2021/22 tax year from your accountant will be required. The statement must be on letter head, have a wet signature, and state your earnings before tax.

Additional Information

How many miles from College do you Live? *

Do you currently receive travel from your local authority/council, or are you in the process of applying for this? *

Yes

No

What other means of transportation will you use?

Do you have access to a computer or laptop at home? *

Yes

No

Do have access to the internet at home? *

Yes

No

How many other people are in your household?

Person 1 - Name

Relationship