Jones & Wagener. 1.1 Surname. 1.2 First names. 1.3 Date of birth M F (please indicate) 1.5 Ethnic origin. 1.6 Current Grade/Year of study

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1 Jones & Wagener Engineering & Environmental Consultants 59 Bevan Road PO Box 1434 Rivonia 2128 South Africa Tel: (0) Fax: (0) Recent colour photograph (Compulsory) Please print clearly in black ink. BURSARY APPLICATION 1. Personal details 1.1 Surname 1.2 First names 1.3 Date of birth 1.4 Sex M F (please indicate) 1.5 Ethnic origin 1.6 Current Grade/Year of study 1.7 Disability 1.8 Citizenship 1.9 ID number 1.10 Drivers licence (e.g. R.S.A. Code 8 etc.) 1.11 Residential address Post code 1.12 Postal address Post code address 1.15 Contact telephone number(s) 1.16 Alternative contact number (relative)

2 2. Academic record (Secondary education) 2.1 High School where matriculation examination was taken/ is being taken Name of School City/Town Year of matriculation 2.2 Matriculation results/ latest academic term results for current matric students Subject Percentage Achievement level Average 2.3 Prizes and awards (Please list any prizes and awards you have received during your High School career, indicating the criteria according to which they were awarded. Please use an extra sheet if necessary.) 2

3 2.4 Extra-curricular activities (Please list extra-curricular activities and achievements.) 3. Academic record (Tertiary education) (PLEASE ATTACH FULL OFFICIAL ACADEMIC RECORD) VERY IMPORTANT 3.1 Name of tertiary institution 3.2 Qualification enrolled for (B.Eng /B.Sc) 3.3 Current year of study (e.g. first, second etc.) 3.4 Prizes and awards (Please list any prizes and awards you have received during your tertiary education, indicating the criteria according to which they were awarded. Please use an extra sheet if necessary.) 3

4 3.5 Extra-curricular activities at Tertiary Level. 4. Financial situation 4.1 If your bursary application to Jones & Wagener is unsuccessful, how will your studies be funded? 4.2 Do you currently hold any other bursaries Y N (please indicate) If you answered No in question 4.2 please go to Section Please name the institution from which you currently hold a bursary. 4.4 Are you required to work for the institution named in question 4.3 after completion of your studies? Y N 4.5 For how many years? 4.6 Should your bursary application to Jones & Wagener be successful, do you wish Jones & Wagener to take over your financial responsibility towards the institution named in question 4.3? Y N 4.7 What is the value of your financial responsibility towards the institution named in question 4.3? 4

5 5. General information 5.1 Why have you chosen your direction of study? 5.2 Which particular field of Civil Engineering are you most interested in and why? 5.3 Hobbies and interests (Please list any hobbies and/or special interests) 5.4 What would you like to achieve in the next ten years? 5

6 6. Quiz Please answer the following questions: 1. You paid R100 for an article, including 14% VAT. What is the cost of the article excluding VAT? 2. You have to design road bridges across the rivers below. Please sketch below the shape of the bridges that you think would be suitable designs. 300m Solid rock cliffs Solid rock cliffs River 500m River (3m deep) Good ground Soft clay layer (2m thick) Solid rock 500m 6

7 7. Declaration Before you sign the declaration below; please check that your application is complete? ITEM Colour photograph attached on page 1 Valid and contact number provided Latest official academic record / report attached Copy of Identity document attached All sections and questions completed CHECK (please tick) I declare that the information contained in this application is correct. Signature Date Place 7

8 Jones & Wagener Engineering & Environmental Consultants 59 Bevan Road PO Box 1434 Rivonia 2128 South Africa tel: JONES & WAGENER BURSARY SCHEME Jones & Wagener is pleased to offer a limited number of bursaries for South African B.Eng or BSc Civil Engineering students studying at South African Universities. The bursaries will cover as a minimum university tuition fees, but could also include accommodation and a limited textbook allowance. Current South African tertiary students and Grade 12 scholars are invited to submit applications. The award of bursaries will be carried out based on academic merit, financial need and company specific considerations. Applicants who have achieved less than 70% in both Maths and Physical Science will not be considered. Jones & Wagener is required to implement Black Economic Empowerment and therefore bursaries will be awarded to reflect the population composition of South Africa. Students studying with Jones & Wagener bursaries may be required to do six weeks paid vacation work at our offices in Rivonia or Centurion during the July and/or December recess. After completion of their studies, bursary students will be required to work for Jones & Wagener for a period equal to the period for which the bursary was held. The closing date for applications is 31 July If you have not heard from us regarding your application by 30 September 2017, please consider your application as unsuccessful. Application forms are available from our website The completed forms must be sent to the Bursary Administrator at the Jones & Wagener preferably by to bursaries@jaws.co.za or alternatively by post to PO Box 1434, Rivonia, Suggestions on completing your bursary application form. The competition for bursaries is very tough. Having no prior knowledge of the applicants, Jones & Wagener has to gather all the information about whom to invite for a bursary interview from the application form. Please ensure that the form is completed in full and in legible writing. Academic results play the most important role in our decision; it is therefore essential that you provide us with the most recent, complete and clear academic record. In completing the other questions, remember that you are marketing yourself and your interests and abilities. It is therefore important to spend some time to think carefully about what to write. Best of luck with your application! JONES & WAGENER (PTY) LTD REG NO. 1993/002655/07 VAT No DIRECTORS: GR Wardle (Chairman) PrEng MSc(Eng) FSAICE JP van der Berg (CEO) PrEng PhD MEng FSAICE D Brink PrEng BEng(Hons) FSAICE JE Glendinning PrSciNat MSc(Env Geochem) MSAIEG TM Ramabulana BA(Social Sciences) A Oosthuizen(Alternate) PrEng BEng(Hons) MSAICE TECHNICAL DIRECTORS: PW Day PrEng DEng HonFSAICE PG GagePrEng CEng BSc(Eng) GDE MSAICE AIStructE JR ShamrockPrEngMSc(Eng) MSAICE MIWMSA NJ VermeulenPrEng PhD MEng MSAICE HR Aschenborn PrEng BEng(Hons) MSAICE M van Zyl PrSciNat BSc(Hons) MIWMSA MW Palmer PrEng MSc(Eng) MSAICE TG le Roux PrEng MEng MSAICE AJ Bain PrEng BEng MSAICE M Rust PrEng PhD MSAICE M Theron PrEng PhD MEng MSAICE GB Simpson PrEng MEng MSAIAE MSAICE ASSOCIATES: PJJ Smit BEng(Hons) AMSAICE R Puchner PrSciNat MSc(Geol) MSAIEG IMAEG M van Biljon PrSciNat MSc(Hydrogeology) JS Msiza PrEng BEng(Hons) MSAICE MIWMSA RA Nortjé PrEng MSc(Eng) MSAICE MIWMSA C Cilliers PrEng BEng(Hons) MSAICE NW Nxumalo PrEng MSc(Eng) MSAICE DG Johns PrEng MSc(Eng) MSAICE G Harli PrEng MEng MSAICE CONSULTANTS: JA Kempe PrEng BSc(Eng) GDE MSAICE AIStructE BR Antrobus PrSciNat BSc(Hons) MSAIEG FINANCIAL MANAGER: HC Neveling BCom MBL

Jones & Wagener Engineering & Environmental Consultants 59 Bevan Road PO Box 1434 Rivonia 2128 South Africa Tel: 00 27 (0)11 519 0200 Fax: 00 27 (0)11 519 0201 email: post@jaws.co.za Mpumalanga Department

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