SCORPION BURSARY FORM form to UJ BURSARY/STUDENT FINANCE 1
TERMS AND CONDITIONS 1. The bursary is open but limited to UJ (full time) 2 nd year LLB/ BCOM Law & BA Law undergraduate students, for 2018 ACADEMIC YEAR. 2. Applicants must be South African Citizens or immigrants with Legal status to live and study in South Africa. 3. Applicants must be younger than 35 years of age. 4. The bursary is limited to a value of R10 000 (Ten Thousand Rand) annually per student. 5. The bursary will not necessarily cover all tuition fees. Candidates are therefore advised to be prepared to meet other expenses which are associated with their studies. 6. The bursary will NOT be paid in CASH, but Scorpion will pay the institution direct. 7. There will be no cash refunds to the students. 8. Students cannot use the bursary to pay for existing roans or debts. 9. The bursary will not cover failed subjects. 10. The bursary may be renewed annually based on academic excellence. BURSARY APPLICATION CRITERIA/ INSTRUCTIONS 11. Complete form in BLOCK LETTERS. 12. applications will be considered without a full MOTIVATION attached. 13. Incorrect information will lead to your application being disqualified. 14. Please ensure that you provide Parent (s)/ Legal Guardian's Salary Advice and/or State Pension Records/ Social Security Grant documents where necessary. Required documentation Category of applicants a) Certified copy of valid Senior Certificate b) Full Academic record/transcript from 1 st year to date c) Certified copy of valid South African Identity document or study permit (immigrant applicant) d) Certified Salary Advice/State Pension Records or Social Grant Security Grant documents for Parents/Guardian responsible for Applicant s study fees.
SECTION A - PERSONAL DETAILS OF APPLICANT 1. Surname 2. First name 3. Date of birth 4. Place of birth 5. Identity number 6. SA Citizenship Yes 7. Gender Male Female 8. Race African Indian Coloured White 9. Do you have a disability? Yes If YES, describe the nature of disability: 10. Residential address with postal code 11. Postal address with postal code 12. Contact telephone numbers including dialing code Home Parent/ Guardian Cellular Other Contact 13. Email address Yes 14. Have you ever been found guilty of a criminal offence? If yes, please state the nature and date of offence: 2
SECTION B - HIGH SCHOOL ATTENDANCE (Applicant) 1. Name of school 2. School address 3. Province 4. Years attended From: To: 5. Subjects (list them below) Symbol Percentage 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 Please attach a certified copy of a valid Senior Certificate 3
SECTION C - POST MATRIC QUALIFICATIONS (Applicant) 1. Name of highest qualification obtained or currently pursuing 2. Year of Study (please tick) First year Second year Third year Fourth year 3. Status Presently studying Discontinued 4. Student Number 5. Are you staying inside campus/university student accommodation Yes Name of Residence Major Subjects Marks/% List the subjects Auxiliary Subjects List the subjects marks / % NB: ATTACH: latest academic results/ transcript (s) - certified 4
SECTION D - INTENDED STUDY FOR 2017 ACADEMIC YEAR (NB: *LAW related Course or Degree ONLY) 1. Name of Qualification 2. Field of Study 3. Are you receiving any other bursary or loan? Yes If YES, describe below the nature of financial assistance and any obligations involved and provide the name of the institution that granted the bursary / loan assistance: SECTION E- DETAILS OF PARENT/LEGAL GUARDIAN (Details of Parent(s) OR Legal Guardian(s) responsible for your study fees) 1. Surname 2. First name 3. Scorpion Policy Number 4. Identity. I I I I I I I I I I 5. Relationship Mother Father Other, specify 6. Residential address with postal code 7. Posta l address with postal code 8. Contact telephone numbers including dialing code 9. Email address Home Work Cellular Other Contact Attach certified copy of parent/legal guardian s salary advice/state pension records or social grants documents 5
SECTION F: MOTIVATION SHEET Tell us why you should be awarded the bursary: (Additional motivation page may be attached if necessary) 6
SECTION G - DECLARATION 1. I hereby, declare that ALL the information provided in this application form is complete and correct. 2. I hereby, acknowledge that if ANY of the information provided in this application form is found to be incomplete and/or incorrect, my application will be disqualified. 3. Signature of (Applicant ONLY) 3.1 APPLICANT (Name and Surname ): --------------- 3.2 Applicant's Signature: 3.2 Date: 4. Signature of (Parent or Legal Guardian only) 4.1 PARENT/ LEGAL GUARDIAN: 4.2 Scorpion Policy Number: 4.3 Signature: 4.4 Date: