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1 Tel: +27 (0) Website: SSP SCHOLARSHIP APPLICATION FORM 1. GENERAL REQUIREMENTS Scholars who meet the following criteria may apply: GAUTENG CLOSING DATE: 31 August 2015 Currently in grade six (2015) 12 years or younger in 2015 Attaining an aggregate of 70% or above in their latest report Attaining 70% or above for Math, Natural Sciences and English Demonstrate financial need. Household income not exceeding R per month. 2. APPLICATION PROCEDURE 2.1 Complete the attached SSP application form (SECTION A, B, C and D) to be considered. 2.2 Attach copies of the following items to the completed form: a) The applicant s latest term report card Grade 6 March 2015 as well as Grade 5 December 2014 School reports b) Copies of the following items: o The child s birth certificate o Copies of parent (s) Identity Document (ID) Where applicable - Parent (s)death certificate/s Where applicable - Proof of adoption If employed: o Please attach latest pay slip o Please attach latest three months bank statements If unemployed o Affidavit from the police station verifying unemployment o Please attach latest three months bank statements o Where applicable - Evidence that you receive government grants If self-employed o Please provide latest company three months bank statements and cash-flow statements c) Please attach a credit report from Transunion; call for a free credit report and have a receiving fax number or address handy. IMPORTANT NOTICE TO PARENTS /GUARDIANS/CAREGIVERS Submitting an application form does not guarantee the awarding of the scholarship. Applicants need to qualify and complete the selection process before being considered for the scholarship. The decision to award the scholarship rests solely with the Student Sponsorship Programme. Incomplete applications and applications that do not meet the SSP criteria will be rejected. In these cases, no correspondence will be entered into. Only qualifying applicants will be contacted. Non South African citizens attending South African schools need to have valid refugee status documents in order to apply.

2 2 3. THE APPLICATION FORM 3.1 SECTION A Scholar Information Please complete this section fully. It is important to fill in all details. The demographic questions and details about the applicant s current school asked in this section are for identification, research and statistical purposes. 3.2 SECTION B Parent/Caregiver/Guardian Information This section is included to establish a primary contact person and to identify all primary caregivers of the scholar in question. All people who fit into the following categories are considered primary caregivers and must be listed in this section: All parents All people who act in the place of a parent and who live with the scholar most of the time. All people who act in the place of a parent, who do not live with the scholar, but who share full financial responsibility of the scholar. The name and contact details of the parent/caregiver/guardian s spouse or partner must also be included. The details of the parent/caregiver/guardian s employment and the number of people in any one household are important for statistical purposes and to assist us in determining the financial need of any particular family. The gross monthly income received by each parent/caregiver/guardian must be declared. Any income from other sources, not stipulated on a payslip must also be declared in the Other income section. This includes, but is not limited to the following: child support grant, pension grant, disability grant, child maintenance, life or other insurance moneys, income received from government tender processes, income from self-employment/private business, income from informal trading and any commission earned over and above regular income. Any adults who live with the scholar and are caregivers of the scholar, but do not contribute directly to the scholar s living costs, must still be included as a primary caregiver if they contribute in other ways to the household. All expenditure within the scholar s household must also be recorded. This includes all monthly expenditure such as rental/bond payments, car instalments, groceries, school fees, transport, clothing and other accounts, etc. Please tick all relevant items included in your monthly expenditure. IMPORTANT NOTICE: If awarded the SSP Scholarship, the successful candidates will be required to attend school at SSP selected partner school. Tuition, and a small stipend to cover books, uniforms and stationery, will be payable by SSP. Parents will be responsible for transport to school and daily meals. Completed application forms (pages 4 6) should be ed to scholarship@ssp.org.za OR faxed to on or before 31 August 2015 with all the necessary documentation in 2.2 (noted above). Interviews and entrance examinations will be held for qualifying shortlisted candidates during the course of September to November The sole right of selection lies with the Student Sponsorship Programme.

3 3 COMPLETED APPLICATION FORMS MUST BE HAND-DELIVERED TO ONE OF THE FOLLOWING PLACES: From Monday 1 June 2015 until Monday 31 August 2015 Monday to Friday submit to: SSP Offices: NBC Building 76 Juta Street Braamfontein Please identify your nearest library from the following list: Bosmont Library Cnr. Maraisburg and Griffiths Roads Ivory Park Library Erf 4326 Makhaya Drive Brixton Library Cnr Mercury and High Street Randburg Library Cnr. Braam Fischer Drive and Selkirk Drive Tshiawelo Library Recreation Centre, 671 Tshianda Street Klipspruit Children s Library 79 Letsatsi Street City of Johannesburg Alexandra 3rd Avenue Library rd Avenue, Alexandra Johannesburg City Library Beyers Naude Square, Cnr. Market & Fraser Street; Johannesburg CBD Diepsloot Library Diepsloot Youth Centre, Diepsloot Hillbrow Library 30 Olivia Road Hillbrow Malvern Library Malvern Plaza, Cnr Jules & Bartle Street Rosettenville Library Shop L10, Centro Continental, Mabel Street Orlando East Library 6544 Mooki Street Sandton Library Nelson Mandela Square, West Street Yeoville Library Cnr. Raleigh Street & Bedford Road Eldorado Park Ext 2 Library J.D Opperman Centre, 3592 Sneeusberg Street The Boulders Shopping Centre (Information Desk) Old Pretoria Road, Midrand Lenasia Ext 1 Library Civic Centre, Cnr Rose Eve& Eland Street Diepkloof Zone A Library 227 Jack Klipin Road Ekurhuleni Pretoria Boksburg Library Trichardt Street, Boksburg CBD Atteridgeville 43 Ramushu Hall, Ramushu Street Germiston Library Germiston Civic Centre, Cnr Queen and Cross Street Alberton Library Voortrekker Road, Alberton Pretoria Central Sammy Marks Square, Cnr Church and Prinsloo Street Soshanguve X 372 Block X Soshanguve Mamelodi Mahlasedi Masana Benjamin Seema Street

4 SCHOLARSHIP APPLICATION FORM SECTION A Scholar Information to be completed by the scholar/applicant GAUTENG 4 CLOSING DATE: 31 August Surname: First Names: Gender: F M Nationality: Birth Date: / / Day Month Year Contact No.: (h) (cell) Permanent Physical Address: Current School Name: Current Grade: Principal s Name: SECTION B Parent/Caregiver/Guardian Information to be completed by the head of the household What is your relationship to the applicant? Parent Relative Legal Guardian Caregiver Other Your Full Name: Employer: Gross Monthly Income: R Your Contact Details: (w) (h) (cell) Spouse/Partner s Full Name: Employer: Gross Monthly Income: R Spouse/Partner s Contact Details: (w) (h) (cell) Number of people in your household, including yourself: Other Income: R Total Monthly Expenditure: R Please specify the source of Other Income, if applicable: Your family s expenditure covers the following items (please tick): Your family s expenditure covers the following items (please tick): Home rental OR Bond Vehicle repayments & Insurance Transport Life Insurance Pension OR Provident Fund Clothing and other accounts Personal Loans OR Credit Card Medical Aid School OR University Fees Telephone bills Water & Electricity bills Entertainment Groceries Child Maintenance Other If Other, please specify:

5 5 SECTION C To be completed by the scholar/applicant Write a paragraph, maximum 60 words, starting If I was a CEO of a company, I would...

6 6 SECTION D Parent/Caregiver/Guardian Information to be completed by the head of the household How did you hear about the SSP Scholarship? Library Radio Newspaper School Word of mouth DECLARATION I,, sign to acknowledge that I understand the terms and conditions set out in this document, that the information I have provided, is true and accurate and that the written work submitted is the work of the applicant, unaided by any other person and is written in the applicant s own hand. Signed: Date: Submit your completed application form to the listed library or to scholarship@ssp.org.za OR fax to on or before 31 August 2015 with all the necessary documentation in 2.2 (noted on page 2).