Bursary Application. 4. All relevant documents as requested in the checklist MUST be attached to your application.

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1 Bursary Application 2017 Please read the following before filling in the application form 1. Dell South Africa has a limited number of bursaries, which have been made available to people who the Company deems to be the most suitable and who qualify academically to further their studies. 2. The fact that you have submitted an application does NOT mean that you automatically qualify for a bursary. The management of our scholarship programme will make this decision. 3. This form MUST be completed in all respects. 4. All relevant documents as requested in the checklist MUST be attached to your application. 5. The original must be delivered and NOT faxed to your financial aid office 6. All family income to be disclosed and substantiated in full. 7. Although this bursary is paid directly to the educational institution on behalf of the student, it is the student s responsibility to furnish the company with his/her results as stipulated in the Contractual Agreement. 8. Your application will NOT be considered if you already hold a scholarship/bursary from another company or organization. 9. Dell South Africa may request that the recipient, upon completion of his/ her studies, to complete an internship program at Dell. Further details will be made available upon acceptance. 10. All successful bursary recipients will be required to sign a contractual agreement. 11. Please submit completed application forms to your financial aid office at your campus within the requested time frames 12. Our preference is studies within the following fields: Engineering, Computer Science, Information Systems, Information Technology, Bcom General, Bcom Accounting, Bcom Financial Accounting Surname First name Year of Study Year-end average Gross earnings of Household per annum Degree & Majors Citizenship Date of Application Attach ID Photo FO OFFICE USE ONLY: Date Application received Amount Approved Date Approved/ Declined Bursary Approved By

2 Section A Personal details Surname First Names Date of Birth Identity number Age Where were you born? (Town & Country) Nationality Disability (if applicable) Where do you intend to staying while studying? esidential/home address Student Address Home Telephone code & Number Cell phone Number Address

3 Section B Parents/Guardians details Guardian: FATHE MOTHE Surname First Names Date of Birth Home Address Home Telephone code & Number Occupation Employer Employer phone number Duration of employment (months/years) Number of children under the age of 18 Ages Number of post matrics in the house Gross Income per month Total household expenses per month Total Family gross income per month

4 Section C Educational Background (Must be completed by all applicants) Name of High School which you presently attend Town/City Province What year are you in Student no. List your matric subjects, your latest results and level (standard/ higher grade), as well as attach proof of your completed results to date Subject: Symbol Level Subject: Symbol Level Average mid-year mark (Percentage) Promoted? YES NO What degree would you like to study for next year? Name of University which you would like to attend? Have you been accepted by this institution? What year would you qualify for next year?

5 Section D General Information (Must be completed by all applicants) Describe yourself in 50 words or less: Give reason for requesting financial assistance: Why did you choose this particular course and how do you intend utilizing it?

6 Section D Continue Further particulars you wish to give in support of your application? What courses will you study next year e.g. Economics 178 Other bursaries you applied for? What eply have you received?

7 Section E Financial Details Note: Please ensure that you research the cost of the various funding categories thoroughly when filling in the requested column. These must reflect the actual amount that needs to be paid. egistration fees: Tuition fees: esidence fees: Books: Meals: Travelling: Other: Actual requirement as per institution Should reflect the sum of the individual courses you intend to study next year Actual amount and not estimates To be reasonable estimate The sum of the daily food allowance if staying at a self-catering residence Provide a schedule of daily travelling expenses if you are not staying in res. please explain in detail and provide proof of cost DESCIPTION AMOUNT: AWAD (For office use) egistration fees: Tuition Fees: Books per year: esidence fees per year: Meals per year Travelling per year Other 1* Other 2* TOTAL: *Please explain in full what these expenses are needed for: Other 1* Other 2*

8 Section F eferences Names of persons prepared to recommend you to study this course not a family member) 1. Title, First name & Surname Occupation Telephone code & number Address 2. Title, First name & Surname Occupation Telephone code & number Address Declaration by Applicant I hereby confirm that I (student name) have read and attached all applicable documents as listed in the checklist which accompanied the issue of this application form. I have read the information and understand it. I understand that my application form WILL NOT be considered unless the form is fully completed and all the requested documents are attached. I agree that Dell South Africa and its bursary administration may confirm the details I have provided. I confirm the above information is true and correct. I will accept the final decision of Dell South Africa. SIGNED ON THE DAY OF 201_. APPLICANTS SIGNATUE

9 Bursary Application Checklist NAME STUDENT NUMBE Before delivering your application, use this checklist to make sure that you have completed your application and attached all the required document Incomplete Applications will not be considered. DOCUMENTATION: 1. A certified copy of your South African ID document or passport. 2. A recent photograph of yourself. 3. A certified copy of your latest examination results 4. A certified copy of your matric certificate (when available) 5. Proof of acceptance to the Educational institution to which you have applied 6. egistration fees 7. Tuition fees by course you intend on studying in the following year 8. esidence fees official residence fees indicating full service or self-catering 9. Meals provide schedule of daily food allowance if staying in self-catering residence 10. Travelling provide schedule of actual daily travelling expenses if not staying on campus 11. If your parents or guardians are deceased or divorced provide a copy of death certificate or divorce decree (including details of any maintenance payments) 12. If your parents or guardians are unemployed a sworn affidavit signed by the unemployed person before a commissioner of oaths proving unemployment must be provided 13. If your parents or guardians are employed provide the most recent pay slip for each person, giving full details of gross income and all other benefits 14. If either of your parents or guardians are pensioners a certified copy of their pension slip must be provided 15. If either of your parents or guardians work in the informal sector or own any business provide an audited financial statement or sworn affidavit indicating estimated gross monthly income. PLEASE ENSUE THAT ALL DOCUMENTATION IS ATTACHED TO THE BACK OF YOU APPLICATION FOM.