RICHARDS BAY COAL TERMINAL PROPRIETARY LIMITED COMMUNITY BURSARY FUND APPLICATION FORM FOR TERTIARY EDUCATION FULLTIME STUDIES AT UNIVERSITY NB: APPLICANTS WHO RESIDE WITHIN THE UTHUNGULU DISTRICT MUNICIPALITY AREAS WILL BE GIVEN FIRST PREFERENCE Page 1
1. Only applications in respect of the following disciplines will be considered for 2019. Please mark your choice with a tick in the appropriate block below Discipline Tick B Sc. Mechanical Engineering B Sc. Electrical Engineering ND Mechanical Engineering ND Electrical Engineering Bachelor of Commerce (Accounting) Bachelor of Education (Maths and Physical Science as Major Subjects) Closing date: 28 th September 2018 Applicants who do not receive communication from the Bursary Administrator on or before 31 October 2018 must please accept that their applications were unsuccessful Page 2
Rules and instructions Please read these notes carefully before you complete the application form. Make sure that you read every section and that the information you provide is accurate. 2. Applicants who reside within the King Cetshwayo District Municipality areas will be given first preference 3. This form is to be completed by the applicant applying for the bursary 4. Please furnish all the requested information. Incomplete application forms will not be considered. 5. An applicant who is found to have submitted false information will be automatically disqualified from being considered for the bursary. 6. Applications received after the closing date will not be considered 7. Failure to submit all required supporting documents will result in the application being disqualified 8. Financial need of each applicant will be taken into consideration when assessing the applications 9. Shortlisted applicants will be notified and asked to participate in an assessment programme. 10. Documentary proof (certified copies of school/tertiary reports, academic results, certificates, etc) in respect of all academic results and achievements stated in application form must be submitted with the application form. Failure to do so will result in the application being disqualified. 11. Please do not send original documents. Attach certified copies of documents to the application form. 12. Completed application forms must be emailed to Mandy Smith at mandy.smith@rbct.co.za before the closing date. Page 3
1. Personal details of applicant Surname Full names Race (for stats purposes only) Gender ID Number Place of birth Do you reside within the King Cetshwayo District Municipality area? Yes or No: Postal Address Residential address Telephone: Cell phone: Email: 2. Parent / Guardian Details. Surname Full names Relationship to applicant Postal address (home). Telephone (home). Telephone (work). Work address (physical) Position:... Number of dependents:... Residential address Cell phone:. Work address (postal).... 3. Details of current/last learning institution attended Name of Institution Page 4
High School:... Tertiary:... Write the name of the studies you want to follow at the university or the current course of study (qualification) you are doing at the university in the dotted line below and tick the current level of study :... Name of University: Please encircle the year of study a. 1 st year b. 2 nd year c. 3 rd year d. 4 th year 4. Bursary Information. Please note that bursaries will only be awarded for FULLTIME study at the University What career do you wish to follow? State the academic year / level of study for which you are applying for a bursary for next year. Duration of study period for the Diploma/Degree for which you are applying for a bursary? Years Months Do you have a bursary at present? Have you had a school or tertiary bursary in the past? Do any of your brothers or sisters have a bursary? Have you ever failed a year / semester of study? Have you previously interrupted your studies Have you ever changed your direction/field of study? Do you, or have you ever held any position of leadership or have you been awarded for special achievements? NB: Attach certified copies of certificates. Yes No If yes, from whom: Value of the bursary R. Yes No If yes, from whom: Value of bursary R Yes No If yes, from whom: Value of bursary R.. Yes No If yes, please give details:... Yes No If yes, why did you interrupt your studies?... Yes No If yes, please give details... Yes No If yes, please give details Page 5
6. Motivation by applicant Please briefly state why you have chosen this field of study What have you done to find out more about this type of a career? Please indicate the reasons for your application: 7. Required certified copies 1) Applicant ID copy 2) Parent/guardian certified ID copy 3) Applicant Grade11 final year results/reports (scholars) 4) Applicant Grade 12 mid-year results/reports (scholars) 5) Applicant Grade 12 final results/reports (school leavers and university students) 6) Proof of registration/application at a Tertiary Institution (if available) 7) Applicant latest statement of academic results/reports (university students) 8) Shortened Curriculum Vitae (max 1 page including contact details) I hereby acknowledge that the information provided in my application form is true and correct and I confirm that I understand the rules and instructions stipulated in this application form. Signature of applicant: Signature of parent/guardian: Date: Date: Page 6