St Joseph's Theological Institute NPC (Non-Profit Company 2003/009125/08; PBO 930007111; Private Higher Education Institute 2003/HE08/003 ) Tel: 0873538940 TUITION BURSARY 2018 APPLICATION FORM Closing date: 31 October 2017. Please see instructions on last page. Please tick () to indicate your current status: Currently in Grade 12 Matriculated but not in Tertiary Currently in Tertiary Please glue a passport size photo here (head and shoulders) Female Male Please tick the tuition fee bursary for which you are applying (choose one) Please note all programmes are full time study under contact mode of delivery. Rogers-Breetzke Bursary for BA in Philosophy Bishop Barry Wood OMI Bursary for Higher Certificate in Human and Social Development Dr Jerome Skhakhane OMI Bursary for BA in Theology PERSONAL INFORMATION ID Number: Date of birth: d d m m y y y y Passport Number: Nationality: Surname: Email address: Marital Status: Single Married Divorced Number of dependants Religion (if any) Physical Home Address Postal Address (if different) Postal Code Postal Code Page 1 of 8
EDUCATION Highest qualification obtained: Date obtained: Name of school / institution: Contact details of school / institution: Name of Secondary Schools Attended Name of School Dates attended Grade completed Contact details of last school attended: To be completed by current Grade 12s Achievement Level Subjects Grade 11 Grade 12 (June) Current Position in Class 1. English 2. 3. 4. 5. 6. 7. 8. Page 2 of 8
To be completed by those who completed matric Name of Examination: Year of Exam: Subjects Achievement Level Subjects Achievement Level 1. English 5. 2. 6. 3. 7. 4. 8. To be completed by those repeating matric Name of School attending: Exam date: Subjects Achievement Level Subjects Achievement Level 1. English 5. 2. 6. 3. 7. 4. 8. Have you undertaken any post-matric studies excluding full-time University? Yes / No If yes, please give details of course(s) or qualification obtained or currently studying: Extramural activities at school: Other interests and hobbies: Page 3 of 8
FAMILY INFORMATION FATHER Surname: Title: Occupation: Marital Status: Single Married Divorced Deceased MOTHER Surname: Title: Occupation: Marital Status: Single Married Divorced Deceased GUARDIAN 1 Surname: Title: Occupation: Marital Status: Single Married Divorced Deceased GUARDIAN 2 Surname: Title: Occupation: Marital Status: Single Married Divorced Deceased Page 4 of 8
FINANCIAL INFORMATION GROSS MONTHLY INCOME: FATHER: MOTHER: Monthly Income: (before deductions) R Monthly Income: (before deductions) R GUARDIAN 1: GUARDIAN 2: Monthly Income: (before deductions) R Monthly Income: (before deductions) R HOUSEHOLD EXPENSES (MONTHLY AVERAGE) Rent / Bond: R Food R Lights & Water R R Other Dependants / Brothers and Sisters who are studying at School or Higher Institution: Name of Student Institution Amount Total : R OTHER BURSARIES Have you applied for other Bursaries: YES NO If Yes, please name them: Are you currently receiving any other Bursaries: YES NO If yes, please state the name of the Bursary and the amount you have received: Page 5 of 8
DECLARATION OF PARENT/ GUARDIAN OR SPOUSE We (Applicant and Parent/Guardian/Spouse) hereby declare: o that all information supplied is true and correct; o that we accept that all information will be treated as confidential; o that this application is subject to a personal interview. Signed at on this day of 2017 Parent/Guardian/Spouse Applicant SUPPORTING DOCUMENTS CHECKLIST The following supporting documents must accompany your application. Take note of number 7. Please check the box on the right of each item that is included. Your application will not be considered without the documentary proof. 1. Certified copy of your ID document. 1 2. Certified copy of your Matric results (if you had completed Matric) 2 3. Certified letter of your Academic records (Current Grade 12 Students). 3 4. Proof of applicant s Home address 4 5. Certified copies of pay-slip(s) of your parent(s) or guardian. 5 6. Sworn affidavits if your parent(s) or guardian(s) are unemployed. 6 7. A one-page motivation essay why you should be awarded the bursary 7 8. Testimonial by Religious Leader (see page 7) 8 Page 6 of 8
TESTIMONIAL BY RELIGIOUS LEADER I, the undersigned, being the religious leader at, testify as follows concerning the bursary applicant whom I have known for the last year(s). Describe the applicant s home circumstances: Describe the applicant s involvement and participation in the activities of your organisation: I recommend this applicant for a bursary because: Name: Designation: Telephone Number: Official Stamp Signature: Date: Page 7 of 8
NOTES AND INSTRUCTIONS FOR APPLICANT Please read these notes and instructions carefully before completing this form. Be sure to read every section and that the information you provide is accurate. 1. Application forms that are incomplete will be disregarded. 2. Please ensure that you attach proof of academic results. Current Matriculants do not need to provide preliminary results final Grade 11 will suffice. 3. The earlier you apply the better your chances. 4. Bursaries will only be allocated for next year (2018). Your application would not be considered for bursaries, if any, offered in 2019 or thereafter. 5. You must supply all the information requested, or explain why you cannot provide it. 6. Do not send original documents, please attach certified copies. No documents will be returned. 7. A passport size photograph of the applicant must be attached to the top right hand of the front page. 8. Please fill in both your parents/guardians occupations so that we can evaluate your financial need level. 9. Please make sure you supply us with a currently operational email address in the necessary column so we can communicate to you For your information we wish to advise you that our selection process on acceptance of your application may consist of at least one interview. Please post your completed application form with supporting documents attached to: St Joseph s Theological Institute Bursaries 2018 Private Bag 6004 Hilton 3245 Or hand deliver between 08:00 and 16:00 Monday-Thursday to: St Joseph s Theological Institute District Road 546 Cedara Applications must reach us before 31 October 2017 Make sure that you visit our website: www.sjti.ac.za for more information about the bursary application and any updates Page 8 of 8