BURSARY APPLICATION INFORMATION SHEET RETURN APPLICATION FORM TO: RETURN BY. 5 Long Street, Mowbray, 7700, W. Cape, South Africa 31 OCTOBER

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1 BURSARY APPLICATION INFORMATION SHEET Application forms will not be accepted through fax or . Please post forms or deliver by hand. Application forms are available from 1 July each year and may be collected or posted on request. Tel: RETURN APPLICATION FORM TO: 5 Long Street, Mowbray, 7700, W. Cape, South Africa RETURN BY 31 OCTOBER i IMPORTANT INFORMATION ELIGIBILITY Only South African citizens who are resident in the Western Cape are eligible. Students who are in Grade 12 and intend studying for a first degree, diploma or higher certificate. APPLICATIONS Applications may be made for a University OR University of Technology in the Western Cape only. Applications for private institutions or FET Colleges are not accepted. In view of large numbers of applications, only successful candidates will be notified. This will be done by the end of February. AWARDS Awards are made by a Selection Committee meeting in late January and are based on merit and financial need. Where funds are limited priority is given to students who are financially needy and who are from less advantaged communities. Awards are variable and cover a percentage of the cost of tuition and books. ASSET bursaries are not repayable. Bursars are able to access loans to cover the balance and any other costs through a partnership with NSFAS (National Student Financial Aid Scheme.) Loans through NSFAS are repayable but up to 40% may be converted to a bursary depending on successful results. Bursary funds are paid directly to tertiary institutions. IMPORTANT DOCUMENTS TO INCLUDE WITH YOUR APPLICATION Please send certified copies of documents 1, 2 and 3. Check 1. Identity Document (ID) 2. Final School Certificate (if available new applicants only) 3. Latest results from school or tertiary institution (if finals not available) 4. Documentary evidence from all income earners in your home (see Section B) You should submit a certified copy of final results as soon as they are available. Please print clearly and check that you have completed the following application form (4 pages) in full.

2 Application Number: ASSET BURSARY APPLICATION FORM Page 1 0f 4 Office Use only SECTION A: PERSONAL INFORMATION Title Mr Mrs Ms Place of Birth Date of Birth Day Month Year Surname ID Number First Names (in full) Telephone/Home contact Cell phone Home Address Postal Address (if different from home address) SECTION B: FAMILY DETAILS Write on the back of this page if you need to give any other details not covered in this section. How many people live in your house, including yourself? No. of learners in family still at school (Grade R Grade 12), including yourself No. of students in family studying at University or other Tertiary Institution, including yourself Name of Parent(s) or Name of Guardian FAMILY INCOME -Confidential List below all the people in your family/household who receive an income. Surname Initials Approx Age Relationship to you e.g. Mother, Sister, Uncle/Guardian Occupation (including self employment) Monthly Income N.B. Send copies only, (not originals) of pay slips, or pension advice. If any working person does not get a pay slip, they should get a sworn statement (an affidavit) from the nearest police station stating how much that person earns.

3 ASSET BURSARY APPLICATION FORM Page 2 0f 4 SECTION C: SCHOOL DETAILS TO BE COMPLETED BY APPLICANTS WHO ARE WRITING SENIOR CERTIFICATE THIS YEAR AND THOSE WHO HAVE PREVIOUSLY WRITTEN BUT HAVE NOT YET ATTENDED A TERTIARY INSTITUTION 1. Name of school 2. Are you writing your Senior Certificate this year? (Yes/No) 3. If No, what year did you write your Senior Certificate? 4. If you wrote before this year, are you upgrading your marks? (Yes/No) SECTION D: PLANS FOR TERTIARY STUDIES NEXT YEAR NB: Applications for Private Institutions are not accepted TO BE COMPLETED BY NEW APPLICANTS ONLY 1. Name of institution where you intend studying 2. Have you applied to this institution (Yes/No)? a. Have you applied to any other institution(s) (Yes/No)? b. If yes which one(s)? 3. What Degree/Diploma/Certificate Course do you intend studying? (Write out in full 1 st Choice 2 nd Choice 4. Length of Course? (Circle the No. of years) Why have you chosen this Degree/Diploma/Certificate Course and what do you intend doing when you have completed it?

4 ASSET BURSARY APPLICATION FORM Page 3 0f 4 SECTION E: APPLICATION FOR BURSARY RENEWAL TO BE COMPLETED BY APPLICANTS APPLYING FOR A BURSARY RENEWAL AND WHO ARE ALREADY ATTENDING A TERTIARY INSTITUTION. 1. Name of Institution 2. Course for which you are currently registered (Write out in full 3. Student number 4. Year of study (Circle year currently registered) Enter your most recent exam results below: Month Year Subject % or symbol 6. Course for which you are registering next year (Write out in full Additional Bursaries/Loans 1. Were you awarded any other bursaries, loans or scholarships in the present year or last year? (Yes/No) If yes, complete the following: Year By whom granted Value Loan or Bursary

5 ASSET BURSARY APPLICATION FORM Page 4 0f 4 SECTION F: MOTIVATION Motivate your application by writing something about yourself, and your goals in life. If you are applying for a bursary renewal, write about the course you are studying and your experiences as a student so far. SECTION G: CONTACTABLE REFERENCE Give details of one person (except your School Principal) who knows you well and can be contacted for a reference. Name and title (Mr. / Mrs. / Ms.) Occupation: Address Telephone Cell phone SECTION H: DECLARATION I hereby declare that the information given in this application is correct. I understand that if the information is found to be incorrect and does not comply with the conditions of ASSET, the support may be discontinued with immediate effect and legal action may be instituted. Signature of applicant: Assisted by Parent/Guardian: if applicant is under 18 years. Signature of Parent/Guardian: Date: