Only successful students will be advised within two months after closing date THE B, SM & HC GOLDSTEIN BURSARY OBJECTS (TO BE RETAINED BY APPLICANT) The Fund has been established in terms of the Will of the late Henriette Constance Goldstein who died on 4 July 1982 to provide bursaries to assist South African students of promise from their second year and onwards at Universities within the Republic to reach a position as a result of these studies, to contribute to mankind generally and South Africa particularly. Bursaries are to be awarded irrespective of race, colour, creed or sex. In the selection of the candidate the following qualif ications will be considered: (a) The scholastic attainments of the candidates. (b) The moral force of character and the possession of qualities which make for good citizenship. (c) The need for financial assistance to enable the candidate to study at a University. (d) The contribution which the student intends making to mankind and South Africa in particular.
-2-1. The amount of each Bursary shall be fixed by the Trustees who shall have the power to vary such amounts as they in their discretion may deem fit. 2. The Trustees shall have the right to award each Bursary for such period as is estimated to be required by the applicant to cover the course of study proposed or they may withhold the Bursary for any year. 3. Successful Applicants shall arrange for the most senior member of the staff under whom they are studying to send to the Trustees, not later than the 30 th day of June and the 31 st day of December in each and every year, confidential reports on their progress. If, in the opinion of the Trustees, such reports are not satisfactory, the said Trustees shall have the right and be entitled to withdraw the Bursary or Bursaries in respect of any such Applicant for any period subsequent to the date of such unsatisfactory report. 4. Payment of the amount of the Bursary or Bursaries shall be made to the successful Applicant in such manner and in such instalments as the Trustees may from time to time in the exercise of their discretion decide. 5. All Bursaries granted are at the absolute discretion of the Trustees and in the event of an Application being refused or discontinued, no correspondence will be entered into. 6. Each Application shall be accompanied by a recent academic record and two references, one from your most recent tutor, plus one from a suitably qualified person who can attest to your character. 7. Applications shall be made on the attached Application Form to the Bursary Office of the University of your choice, by their closing date. 8. Please quote the name of the bursary in all correspondence.
PLEASE PRINT CLEARLY Please note that all questions must be answered. Failure in this respect will invalidate the application. THE B, SM AND HC GOLDSTEIN BURSARY FORM OF APPLICATION FOR A BURSARY (SECTION 1) 1. SURNAME OF APPLICANT 2. FIRST NAMES 3(a) PERMANENT RESIDENTIAL ADDRESS 3(b) POSTAL ADDRESS 4. NATIONALITY 5. DATE OF BIRTH 6. MARITAL STATUS 7. EDUCATIONAL HISTORY INCLUDING DATE OF MATRICULATION (DOCUMENTARY PROOF REQUIRED)
8. WORK HISTORY (IF APPLICABLE) 9. PART TAKEN IN UNIVERSITY ACTIVITIES AND PERSONAL INTERESTS: 10. (a) FOR WHAT COURSE ARE YOU NOW APPLYING? (b) AT WHICH UNIVERSITY? (c) FOR WHAT YEAR OF THE COURSE? (d) FOR HOW MANY YEARS DOES THE COURSE LAST? 11. TO WHAT USE DO YOU INTEND TO PUT YOUR UNIVERSITY TRAINING AND DEGREE? STATE THE TYPE OF WORK YOU HOPE TO DO WHICH WILL CONTRIBUTE TO MANKIND GENERALLY AND SOUTH AFRICA PARTICULARLY:
12. (a) ARE THERE ANY CIRCUMSTANCES (FINANCIAL OR OTHERWISE) WHICH YOU WOULD WISH TO BRING TO THE ATTENTION OF THE TRUSTEES AS BEING REASONS WHY YOU WOULD WISH TO OBTAIN A BURSARY OR WHICH WOULD PREVENT YOU FROM CONTINUING YOUR STUDIES WITHOUT A BURSARY? THE REPLIES TO THIS WILL BE TREATED AS STRICTLY CONFIDENTIAL AND MAY BE SUBMITTED ON A SEPARATE SHEET OF PAPER IF YOU SO DESIRE. (b) MINIMUM AMOUNT REQUIRED ANNUALLY: (i) FOR FEES R (ii) RESIDENCE (IF APPLICABLE) R (iii) LIVING EXPENSES R (iv) BOOKS R SUB TOTAL LESS: AMOUNT (IF ANY) WHICH YOUR PARENTS OR GUARDIAN MAY BE ABLE TO CONTRIBUTE TOTAL REQUIRED IN THE FORM OF A BURSARY R R R 13. ARE YOU BENEFITING UNDER ANY OTHER BURSARIES OR SCHOLARSHIPS, OR HAVE YOU APPLIED FOR ANY BURSARY OR SCHOLARSHIP? IF SO, GIVE FULL DETAILS:
14. REFERENCES: PLEASE OBTAIN AND ENCLOSE WITH THIS APPLICATION TESTIMONIALS FROM NOT LESS THAN TWO PERSONS, SUCH AS YOUR TUTOR, CHURCH MINISTER, ETC. AS WELL AS A RECENT ACADEMIC RECORD. 15. I HEREBY ACKNOWLEDGE THAT I AM AWARE OF THE CONDITIONS ATTACHED TO THE GRANTING OF THE B, SM & HC GOLDSTEIN BURSARY AND DO HERE SPECIFICALLY UNDERTAKE AND AGREE IN THE EVENT OF THIS APPLICATION BEING SUCCESSFUL TO ARRANGE FOR PROGRESS REPORTS TO BE PROVIDED IN TERMS OF REGULATION 3 ON OR BEFORE THE 30 TH DAY OF JUNE AND THE 31ST DAY OF DECEMBER IN EACH AND EVERY YEAR SO LONG AS I SHALL HOLD THE BURSARY. I CERTIFY THE AFOREGOING, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TO BE TRUE AND CORRECT. SIGNATURE OF APPLICANT DATE
THE B, SM & HC GOLDSTEIN BURSARY (SECTION II) I/We, the undersigned, hereby declare that the following particulars regarding financial circumstances are true and correct and I/we certify that my/our financial position is such that it would be difficult for my son/daughter to study further. (this information is most important and will be treated confidentially) The financial circumstances of the parents/guardian of the applicant must be completed by the parent/guardian. 1. Applicant s name: 2. Names of parent/guardian: 3. Address: 4. Occupations: 5. Valuation of fixed property: Rateable value R R 6. Amount of Bond outstanding (if any): 7. Description (e.g. house, farm (2000 morgen): 8. Value of moveable assets (excluding furniture): 9. Value of investments: 10. Annual gross income of parents (documentary proof required) 11. Amount of last Income Tax Assessment: 12. Number of children maintained by parents:
13. Number of children attending university or college (specify): 14. I/we wish to have the following additional facts to be taken into account: SIGNATURE DATE