Application form 2017-18 Undergraduate Tuition Fee Grant Please read the accompanying guidelines before filling in the form. When making a decision, the Carnegie Trust will consider all the relevant facts about the applicant and awards will be made on the basis of financial need and academic potential. It is therefore important to carefully complete the personal and financial information requested in the form, to answer all the questions fully and to provide all the requested supporting evidence. The form should be completed electronically. If you need to fill it in by hand, please use black ink and write clearly. Part 1: Applicant details A. Personal details Title (Miss, Mrs, Ms, Mr) First name(s) Surname Maiden name (if married) Date of birth (DD/MM/YYYY) Place of birth Marital status Single Divorced Married Separated Living with partner B. Contact details Permanent address Term time address (if different) Address line 1 Address line 1 Address line 2 Address line 2 Address line 3 Address line 3 City Postcode Country Phone number Email City Postcode Phone number Email Mobile Mobile A letter will be sent to your permanent address with the outcome of the selection process so it is essential that the above details are correct and up to date. Please inform the Trust if details change during the selection process. Andrew Carnegie House, Pittencrieff Street, Dunfermline KY12 8AW Tel: 01383 724990 Fax: 01383 749799 Email: admin@carnegie-trust.org Web: www.carnegie-trust.org Scottish Charity Number: SC015600
C. Scottish eligibility and residency status Scottish eligibility By birth One Scottish parent Two full years of secondary education in Scotland Answer the following questions, if you were not born in Scotland OR if you were born in Scotland and coming back to Scotland after living abroad: Date of arrival in Scotland (DD/MM/YYYY) What is your immigration status? If you are claiming eligibility on the basis of birth or descent but do not currently live in Scotland or moved here recently, explain your relationship with Scotland (ancestry, visits etc.) and why you wish to study in Scotland. Part 2: Course and tuition fee information A. Course details Have you previously applied to the Trust for fee assistance? Yes No If yes, academic year in which you applied Scottish university you will be attending in 2017-18 Type of degree (e.g. BSc, BA, MEng, BEng etc.) Course title (e.g. Psychology, Engineering) Have you been accepted on this course? Yes Not yet Is this offer? Conditional Unconditional What year of study will you be entering in 2017-18 (e.g. 1 st year)? Expected year of graduation Are you repeating a year of study? Yes No Mode of study Full-time Part-time Distance learning Part-time Distance Learning Full-time Work based Note: Full-time students: Go to section B; Part-time students: Go to section C Page 2 of 9
B. Full-time students: tuition fee and funding information Please fill in all the details required that apply to you Tuition fee amount for academic year 2017-18: Have you applied to SAAS for tuition fee funding? Yes No What was the outcome of your application to SAAS? What reason was given by SAAS for not funding your studies? Undergraduate Tuition Fee Support Application form Will you become eligible for SAAS tuition fee funding later in your studies? If so, in what year of your course will the funding start? (e.g. 2 nd year) If you have not applied to SAAS, explain why Have you applied to SAAS for a maintenance loan? Yes No How much will your student loan be for 2017-18? If you have not applied for a student maintenance loan, explain why Please give details of any other grants you will receive from SAAS (e.g. Dependant Grant; Lone Parent Grant) Have you applied to any charity, trust or other body for tuition fee support? If your application was successful please provide Name of charity/body Amount awarded C. Part-time students: tuition fees and funding information Number of modules you will be studying in academic year 2017-18 Number of credits for the academic year Amount of tuition fees for the academic year Have you applied to SAAS for a part-time fee grant? Yes No Amount awarded by SAAS, if applicable If you have not applied to SAAS for a part-time fee grant, explain why. Page 3 of 9
Part 3: Education and qualifications to date Undergraduate Tuition Fee Support Application form A. Secondary education School name and location From date To date Qualifications Grades B. College education Provide details of any courses at college on which you were previously enrolled, even if you did not obtain any qualifications. If you did not gain any qualifications, please entre None or N/A in the appropriate field College name and location From date To date Qualifications obtained Grades C. University education Provide details of any courses at university on which you were previously enrolled, even if you did not complete the course. If you did not gain any qualifications, please enter None or N/A in the appropriate field. University name and location From date To date Subject/course title Qualifications obtained Part 4: Work experience If you are entering or returning to Higher Education after a period of professional activity, provide details of your employment history. Employer name From date To date Position held Page 4 of 9
Part 5: Personal statement (Max. 200 words) Undergraduate Tuition Fee Support Application form In this section, give reasons why you should be considered for an Undergraduate Tuition Fee Grant from the Carnegie Trust. You should include details of your ambitions, aspirations and reasons for wanting to study the course you have chosen. You may also wish to include information about your extra-curricular interests and hobbies, especially if these are relevant to your chosen course. If you are returning to Higher Education after a study break, please explain why you did not complete your previous course. You can also mention your work experience, including voluntary roles and state why it is important for you to attend university but would not be able to do so without the Trust s support. Page 5 of 9
Part 6: Financial information A. Family details Applicants who are still dependent on their parents (see Guidelines), please indicate each parent s occupation. If retired, please state the previous occupation and retirement year. Father s occupation Mother s occupation Guardian s occupation (if applicable) B. Household income Description Period Amount Income from salaries, pensions, bursaries or loans Applicant s gross annual income Parents /Guardian s gross annual income Spouse/partner s gross annual income Applicant s student loan per year parental contribution to applicant if applicable Annual Annual Annual Annual Social benefits Tax credits Housing benefits Child benefits Other child support contributions received Weekly Weekly Weekly Weekly Other income Description: Description: C. Household expenditure Household expenditure at permanent address Description Period Amount Rent Mortgage Council tax Gas/electricity Telephone/broadband Groceries Page 6 of 9
Clothing/Toiletries Debt repayments Details of applicant s personal contribution to household expenditure at the permanent address. Please explain below how you financially contribute to meeting the household costs detailed above. D. Applicant s expenditure at term time address Description Period Amount Rent Is the rent paid for by (delete as appropriate) : Applicant OR Parents/guardian Gas/Electricity Telephone/Broadband Groceries Clothing/toiletries E. Applicant s personal expenditure Description Period Amount Study costs (excluding tuition fees) Travel to/from campus Mobile phone Social costs F. Applicant s current financial position Please provide details of all bank, building society, and savings accounts, including ISAs held by you. Names of banks/building societies Agreed overdraft A/C balance Credit or debit? Credit card facilities Page 7 of 9
G. Additional information List all the members of the household (parents, step-parents, guardians, children and any other dependents). Please give the ages of all the dependent children. Is there any other information about your household income or expenditure which you would like to bring to the attention of the Trustees? Part 7: Data protection and undertakings Data Protection Act The Carnegie Trust for the Universities of Scotland is registered under the Data Protection Act 1998 and complies with the provisions of the Act. Applicants are reminded that, in order for the Carnegie Trust to assess applications, it will be necessary to store and process the information sent. Information about applicants may be disclosed for these purposes only to individuals and organisations connected with the Trust, including universities and external referees. Data will be securely held and lawfully processed, it will be kept up-to-date, and not retained for longer than necessary. Data may also be used to compile published lists of award holders, which may be available on the Internet and in our Annual Report. The Trust may contact applicants about its funding schemes, application processes and policies or to help evaluate these. 1. I confirm that I have read and understood the above Data Protection statement. 2. I confirm that, to the best of my knowledge, the information provided in this application is accurate and complete and I agree to inform the Trust of any changes to this information during the period of award. 3. I agree that the reference provided by my referee will remain confidential between the referee and Carnegie Trust. 4. I agree that details of my application may be shared with the university to which the grant will be paid if an award is made. 5. I agree to information regarding my enrolment status, academic results, progression and graduation being shared by the university with the Trust. 6. I have read the Undergraduate Tuition Fee Assistance Regulations and agree to abide by them should an award be made. Candidate, sign or type Date Part 8: Submitting your application A. Supporting evidence checklist When submitting the form online, the following documents (2MB file limit on each document) will need to be uploaded: Proof of Scottish eligibility (applicant s birth certificate, Scottish parent s birth certificate, certificate of school/college attendance for two full years) SAAS letter with details of tuition fee and loan entitlement Acceptance letter from university showing fee amount due The Trust reserves the right to request further details as to the applicant s financial circumstances and may request evidence of the applicant s earnings as well as of their parents, guardians, spouse or partner. Page 8 of 9
B. Reference The online submission form will ask for the name and full contact details of one referee, familiar with your personal circumstances and intellectual abilities. If you are returning to, or entering higher education after a period of professional activity, a reference from a supervisor or manager at your work place would be appropriate. The Trust will contact your referee directly to request a reference. We will do this within four weeks after the submission of your application. To avoid delays, please check with your referee whether he, or she, is willing and available to provide a reference during that time before submitting your application. C. Online submission The form and supporting evidence must be submitted online at: http://www.carnegie-trust.org/schemes/undergraduate-schemes/fee-assistance.html The closing date for applications for 2017-18 is 30 th November 2017. Late or incomplete applications forms will not be considered. Page 9 of 9