National Bursary Application Form

Transcription

National Bursary Application Form
PRIVATE BAG X04
NORTHLANDS
2116
FAX:011 483-0881
www.nfvf.co.za
87 CENTRAL STREET
HOUGHTON
2198
TEL:011 483-0880
[email protected]
FILM FUND: APPLICATION FORM FOR A NATIONAL BURSARY
(INSTITUTIONS IN SOUTH AFRICA)
FOR OFFICE USE ONLY
Ref No.
Date of Receipt
CLOSING DATE: -8/< 201 at 12h00
Note: Extensions will not be granted
The NFVF does not fund Live performance (Acting) studies
TITLE
SECTION 1: CONTACT DETAILS
FIRST NAME
ID NUMBER:
POSTAL ADDRESS
POSTAL CODE
PROVINCE
STREET ADDRESS
POSTAL CODE
PROVINCE
TELEPHONE NUMBER
FAX NUMBER
CELLPHONE NUMBER
E-MAIL
1
SURNAME
SECTION 2
GENDER: Male
Female
RACE:
Do you have any disability?
Are you a South African citizen?
If Not please state citizenship
Are you a South African resident?
If Not please state country of residence
Is this your first application?
SECTION 3: COURSE DETAILS
3.1 Intended Degree/ Diploma
3.2 Duration of course:
3.3 Current year of study and majors:
SECTION 4: INSTITUTIONAL DETAILS
4.1 NAME OF THE INSTITUTION:
4.2 POSTAL ADDRESS
POSTAL CODE
2
4.3 CONTACT PERSON IN THE DEPARTMENT
TITLE
SURNAME
FIRST NAME
TELEPHONE NUMBER
FAX NUMBER
CELLPHONE NUMBER
E-MAIL
SECTION 5: FINANCES
5.2 OTHER SOURCES OF FUNDING
If you have applied for any financial assistance for the same purpose to any other
source(s), please give full details
Name of Company Amount
Approved
Awaiting
approval
TOTAL FUNDING RAISED
5.3 FAMILY INCOME 0867&203/(7($1'3522)72%(68%0,77('
FATHER:
MOTHER:
GUARDIAN:
OTHER PLEASE STATE:
5.3 PLEASE STATE THE COMBINED PARENTS' INCOME:
3
Please submit the following documents with the application form
 A one page letter of motivation from the applicant stating why they need the
funding, where they think their studies will lead them and how they think their
chosen field will benefit their community andSouth Africa as a whole.
 Letter of acceptance from the institution or letter of acknowledgement of their
application.
 Updated Study Fees breakdown from the institution for the year in which funding
is required
 Certified copy of Identity Document. (Not later than three months)
 Latest Academic Results and Matric Certificate (only certified copies will be
accepted)
 Parents' proof of income or other financial support if any i.e payslips together with a
2 months bank statement, proof of social grants. If independent, please also
include your own payslip and 2 months bank statements. (only certified copies will
be accepted)
 If you are studying on a loan or have received a bursary from other financial
institutions please submit the relevant documentation.
 Submit only one copy of your application form including one copy of each
document required.
PLEASE NOTE:
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Do not fax or email applications. (Please post to the NFVF address)
Failure to provide all requested information will lead to automatic
disqualification of the application.
No late application will be considered.
The final allocation is subject to the NFVF verifying all the information
submitted by the applicant.
NFVF has previously experienced problems with contacting applicants at
addresses and contact numbers provided. Should the applicant or recipient not
be contactable for 2 months at the given address or contact number from the
date of receipt or grant the application or the grant will be cancelled, should
there be a change of contacts the onus is on the applicant to notify NFVF.
The closing date for submission of applications is 31 JULY 2015, 12h00.
Applicants will be advised of the decision in writing by 19 December 2015
No applications shall be returned to the applicant.
Do not submit any extra material, e.g. videos, photographs, etc. (unless
requested).
NFVF bursaries are only available to South African citizens, applicants with
permanent residency or those with refugee status.
For any queries, please contact Lebohang Khunou, Tel: 011 483 0880 or
[email protected]