ALUMINIUM SA BURSARY SCHEME BURSARY APPLICATION FORM TERTIARY EDUCATION (FOR STUDY AT UNIVERSITY/ UNIVERSITY OF TECHNOLOGY 2010) CLOSING DATE: 31 JULY 2009
RULES AND INSTRUCTIONS: Please read these notes carefully before you complete the application form. Make sure that you read every section and that the information you provide is accurate. Mark your choice with a cross in the appropriate block where applicable. NB: Only applicants who reside in the Uthungulu Region will be considered. Only applications in respect of the following disciplines will be considered:- Degrees (University): Engineering (Mechanical, Electrical (Light or Heavy Current), Chemical, Metallurgical) Environmental Studies, Computer Science, B Comm Accountancy, Human Resources National Diplomas (Technikon): Engineering - Mechanical, Electrical (Light or Heavy Current), Chemical, Metallurgical 1. 2. 3. This form is to be completed by the person applying for the bursary. Please furnish ALL the information requested. Incomplete application forms will be disregarded. An applicant who is found to have submitted false information will automatically be disqualified from being considered for a bursary. 4. Only original application forms will be accepted. Do not fax application forms. Do not send application forms per registered mail. 5. Applications received after the closing date will NOT be considered. 6. Bursaries will only be allocated for the year following the one in which the application is received. 7. Applicants' academic achievements in languages (Level 5), mathematics (core topics) (Level 6), accountancy, physical science (Level 5) will be important criteria when short listing applications for present Grade 12 learners and HG C for those who have already passed Grade 12. Reports must accompany application forms. Failure to submit ALL reports in support of results furnished on application forms will result in the application being disregarded. 8. Financial need will be taken into consideration. The joint GROSS income (i.e. before deductions) of both parents must be reflected on the application form. Parents/guardians of successful applicants will be required to sign a sworn Affidavit before a Commissioner of Oaths verifying that the income information stated on the application form is true and correct. Pay slips must accompany application forms. Failure to submit this information will result in the application being disregarded. 9. Short listed applicants will be notified by telephone / sms if they have been shortlisted to participate in the assessments. 10. Documentary proof (certified copies of school/tertiary reports, academic results, certificates, etc) in respect of all academic results and achievements stated in this application, must accompany the application form. Failure to submit the relevant certified documents with this application will result in the application being disregarded. 11. Please do not send original documents. Attach certified copies of documents to the application form. 12. A passport photograph of the applicant must be attached to the application form. Please note that if any information or documentation provided in support of this application is later found to be incorrect or untrue, and a bursary is awarded, an enquiry will be held and depending on the outcome, the bursary may be cancelled and all bursary monies paid plus interest will have to be repaid to the Scheme immediately by the bursars parents. Completed application forms must be posted to the Bursary Fund Administrator, ADSEC, P.O. Box 8154, Bonaero Park, Gauteng 1622, Please do not send application forms by registered mail. Applicants who do not receive a communication from the Bursary Administrator by 30 November 2009 must please accept that their application was unsuccessful.
PASTE PHOTOGRAPH HERE ALUMINIUM SA BURSARY SCHEME APPLICATION FOR BURSARY - UNIVERSITY OR TECHNIKON CLOSING DATE : 31 JULY 2009 1. Personal Details of Applicant Surname Full First Names Male / Female (Please delete which is not applicable) (for statistical purposes only) Date of Birth Race (for statistical purposes only) ID No Place of Birth Nationality Do you reside in the Uthungulu region? Yes/No State where: Home Language Postal Address Residential address: Postal code Contact telephone number Second contact tel. number 2. Parent / Guardian Details. Surname Dialing Code: Dialing Code: Initials Relationship to applicant Postal Address Residential Address Postal Code Telephone Number (H) Work Address Income of parents/guardian (Proof of JOINT Gross Monthly income BEFORE deductions - Pay slips etc must be attached to this application form failure to submit this information and documentation will result in this application being disqualified Father per month Telephone Number (W) Occupation No of children in immediate family (under 18 years) Ages of children in family (under 18 years) Mother per month Other (Successful Applicants will be required to sign an Affidavit before a Commissioner of Oaths verifying that the information provided is true and correct)
3. Details of current High School/Tertiary Institution. Name of current School/Tertiary Institution Address of School/Tertiary Institution Telephone No. State current course of Study, e.g. Grade 12 / B Com / N Diploma. University : (Tick current level) University of Technology : (Tick current level) * 1 st year 2 nd year 3 rd year 4 th year S1 S2 S3 S4 * Tertiary students, please be specific - i.e. state discipline/major : e.g. B Com Accountancy / N Diploma Mechanical Engineering. 4. Bursary Information. NB Please note that bursaries will only be awarded for FULLTIME study at a University or University of Technology (Technikon) What career do you wish to follow? Have you applied to be accepted at a University/University of Technology for 2010. (Very important to do so as soon as possible as the closing date for many courses can be as early as June). Please state name of educational institution that you have applied to for 2010. What direction of study do you wish to pursue? State the academic year / level of study for which you are applying for a bursary for next year. Duration of study period of Degree/Diploma for which you are applying for a bursary? Years Months If you have already matriculated, please state the name of the school you attended and in what year School Year Have you ever applied for a bursary through this scheme before? Do you have a bursary at present? Yes No If yes, from whom Have you had a school or tertiary bursary in the past? Do any of your brothers or sisters have a bursary? Have you ever failed a year / semester of study? Yes No If yes, Did you apply for a school or tertiary bursary? Were you invited to attend an assessment centre at the Careers Centre? Yes / No. If yes, please state year. Yes No If yes, from whom Yes No If yes, from whom Have you previously interrupted your studies Have you ever changed your direction/field of study? Do you, or have you ever held any position of leadership or have you been awarded for special achievements? Yes No If yes, why did you interrupt your studies? NB Attach certified copies of certificates.
5. Complete the following table. NB Attach certified copies of reports. Please list the subjects and results that you are studying in the current academic year plus those that you studied in the previous two years. Remember application forms not supported by certified copies of reports, academic records (and achievement certificates if applicable) will be considered as incomplete and disregarded. Current first Year University /University of Technology students: List Grade 12 subjects as well as results achieved since attending University/Technikon. First term results for the current year must also be furnished if possible. Grade 12 students: Furnish the results / percentages achieved in the most recent examination and specify which examination they represent (e.g. first term). Also furnish results of previous 2 years. English Afrikaans IsiZulu Grade 12 Learners Subject Gr10 Gr 11 Level Mathematics (Core) (NB SEE NOTE BELOW) Mathematics Literacy Physical Science Accountancy Geography Computer Science Other Subjects: Gr 12 / Level University and University of Tech. students Subject 1 st year/ S1 2 nd year/ S2 3 rd year/ S3 MATHEMATICS PLEASE SPECIFY WHETHER MATHEMATICS CORE OR LITERACY 6. Motivation by applicant Please indicate the reasons for your application i.e. please state briefly:- 1) why you have chosen this field of study 2) What have you done to find out more about this type of career? 3) Details of any work experience. 1) 2) 3) 7. Motivation by Principal (in respect of Grade 12 learners) or Faculty/Department HOD (in respect of tertiary students): Signature: Date: Stamp - educational institution I hereby acknowledge that my application form is true and correct and I confirm that I understand the rules and instructions stipulated in this application form. Signature of Applicant Supported by Parent/Guardian (Signature of Parent/Guardian) Date