Application form for Council Bursary The closing date for applications is 7 January. DO NOT continue to complete this form if you are not registering / or are registered to study a B.Sc Surveying / Geomatics, B.Tech Surveying / GIScience/Mine Surveying / or Diploma in Surveying / Mine Surveying or GIScience For details & Conditions to which Bursaries are awarded see pages 4 & 5 1. Surname :..... Gender :... 2. First names :... 3. Residential address :... 4. Postal address :.:.. 5. Contact Numbers : Cell ;...Tel No. (Code..)... Fax : e-mail 6. Date of Birth :...Age... Nationality :... Home Language.. Identity No :..... 1
7. SCHOOL / TERTIARY BACKGROUND (a) Name of *School / *University / *University of Technology / presently or last attended ; Place :... Highest Level Obtained ;.....Year ;... If still at school, please give subjects, results (symbols) of last examination and send in matriculation results as soon as they become available. Without these results this application cannot be considered. University Entrance Examinations passed: Province...Year...Class...(Grade / 1 st / 2 nd year) Subjects Symbols Subjects Symbols University of Technology Entrance Examination passed: Province...Year...Class...(S1, S2,etc) Subjects Symbols Subjects Symbols (Certified copies of you final report, certificates, diploma, etc, MUST be attached) 2
8. If you have previously attended, or are presently attending a University or University of Technology please furnish your complete record. (University or University of Technology, Years, Course, Subjects passed and symbols obtained, subjects failed). 9. Which Degree /Diploma / do you intend to Study ;. 10. Current year of study ; 1 st 2 nd 3 rd 4 th 5 th 6th 11. To which University have you applied to study?.. 12. Have you been accepted? Will you be a full time student?... 13. Please furnish the following information in detail: (a) If you don t get enough funding, how will you cover the other University / Technikon costs?........ Do you receive any benefits, grants or loans in respect of the following & how much? (i) Board and Lodging?... (ii) Books?... (iii) Tuition?... Has an Educational Insurance Policy been taken out on your behalf?... (If yes, please state from whom)... Have you previously held, or are you now holding, any bursary, loan or scholarship? (If yes, please state from whom, for how much and for how long) (e) Have you applied for any other financial assistance for the period for which you require the bursary?. (If yes, please state from whom)... 14. (a) Testimonial of * Principal/ *Head of Department attached?... Other testimonials submitted?... *Delete whichever is not applicable 3
Reasons for requesting a bursary. 15. (a) Full name of Parent / Guardian :.... Occupation of Parent / Guardian :...... Address of Parent / Guardian :...... Contact number of Parent / Guardian :.. This form must be completed in every details and all relevant documents must be attached before application can be considered. Matric certificate ID document Tertiary qualifications certificate(s) Latest results for June and November Provisional Letter of Acceptance at University / Technicon Proof of Registration at Institution 16. CONDITIONS TO WHICH BURSARIES ARE AWARDED : (i) that a bursar studying at a University undertakes to register as a Land Surveyor /Professional GISc Practitioner within four (4) years of obtaining his/her B.Sc. Degree in Surveying/GIScience; in the case of a bursar studying for a National Diploma he/she must undertake to register as a Survey Technician / GISc Technician / Mine Survey Technician within two (2) years of obtaining his/her diploma; provided that the bursar may apply to the Council to extend the above periods. (ii) (iii) that should the bursar fail so to register within such period or extended periods as the case may be, or if he has advised the Council, in writing, that he does not intend to proceed to such registration, the bursary shall convert to a loan, and such loan and any other loan granted to him by the Council, shall be repayable within four years of such date, extended date or advice date, as the case may be, together with interest calculated at ten percent per annum from the relevant date; that should the bursar fail any year of study in which the bursary is awarded, the amount of the bursary paid to him in that year will be converted to a loan, repayable within four years of completion of the course or within four years of the date on which he abandons the said course, whatever the case may be; and that he may apply to the Council for a loan to enable him to repeat that year of study; provided that such a loan may be granted at the discretion of the Council. 4
(iv) (v) (vi) (vii) (viii) that should the bursar fail a second time no further assistance will be given to him; and that should he pass, he may again apply to the council for a bursary for the following year; that although the bursary is allocated for the normal period of study required to complete the degree/diploma course, it will only be paid out without further need re-apply for it, provided a satisfactory pass mark is obtained and upon receipt by the Council of a satisfactory progress report by the departmental Head of the University/University of Technology. that no interest will be levied on any loans granted if they are repaid within the prescribed periods; provided that failing such repayment, interest calculated at ten percent per annum will be charged in respect of the unwrapped balance of the said loans for the period of repayment extending beyond such prescribed period; that the bursary will be paid out in two instalments, the first in April upon receipt of the University s official statement of account, the second in August upon receipt of a satisfactory Departmental Head s progress report; that the Council reserves to itself the right to alter the conditions, value and/or period of the bursary at any time and that it shall be the sole judge of the bursar s progress at the University. 17. I, the undersigned (full name & surname)...... declare that I, : (a) have signed and completed this form to the best of my ability; attached ALL the relevant required documentation; accept the conditions as specified above; and undertake to enter into an agreement with the S A Council for Professional and Technical Surveyors in respect of the conditions subject to which bursaries are awarded, if a bursary is awarded to me. DATE :...... Signature of Parent or Guardian... Signature of Applicant WITNESSES. 1. (Name & Surname)......TEL NO.. 2. (Name & Surname)......... TEL NO... 5