BURSARY APPLICATION FORM PLEASE NOTE THE FOLLOWING: 1. This form must be completed in your OWN handwriting. 2. Incomplete application forms will not be considered. 3. In line with Johannesburg Water’s bursary procedure, financial aid to students is provided on the basis of academic merit and financial need. Preference will be given to previously disadvantaged individuals, persons with disabilities and females 4. South African Citizens The following documents must accompany your application form: (Do not attach originals. Attach certified copies only) 1. Proof of registration from the institution. 2. A certified copy of your Matric certificate. 3. An updated official transcript of your academic record at the University or University of Technology or or a certified copy of such transcript. 4. Copy of identity document. 5. Copies of parent/guardian ID’s. 6. Copies of parent(s)/guardian(s) salary advice or affidavit if they are unemployed. Completed application forms to be emailed to [email protected] Or posted to: The Assessment & Career Development Section, Johannesburg Water, P.O Box 61542 , Johannesburg , 2107. Closing date for applications is 31 August 2014. Please indicate the name of the bursary (field of study) you are applying for: BSc Engineering (Civil) with 1st year completed National Diploma (Civil Engineering) with S1 completed BSc Chemistry or Bio-Chemistry with 1st year completed Degree or National Diploma in Internal Auditing with 1st year or S1 completed SECTION A - PERSONAL DETAILS OFAPPLICANT 1. Surname 2. First Names 3. Identity No. 4. SA Citizenship Yes No 5. Gender Male Female 6. Race African Indian Coloured White 7. Do you have a disability Yes No If yes, describe the nature of the disability: 8. Residential address 9. Postal address 10. Contact telephone numbers Home Cellular Parent/ Guardian Other contacts 11. Email address NB: Attach copy of your ID SECTION B – EDUCATION HIGH SCHOOL ATTENDED 1. Name of school 2. School Address 3. Grade(Please tick) Currently in Grade 12 Completed Grade 12 4. Years attended From: To: 5 Subjects(list them below) Percentage Symbol 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 Attach proof of latest academic results or academic transcript SECTION C – POST MATRIC QUALIFICATIONS 1. Name of institution 2. Full name of highest qualification 3. Nature of qualification Degree Diploma 4. Status Complete Presently studying Discontinued 5. If currently studying, Which year of study? (Please tick) First Year Second Year Third Year Fourth year 6. If discontinued , for What reasons? 7. Major Subjects Marks / % Obtained List the subjects 7.1 7.2 7.3 7.4 8. Other Subjects Marks / % Obtained List the subjects 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 NB: Attach proof of latest academic results or academic transcript SECTION D – INTENDED STUDY FOR THE NEW ACADEMIC YEAR 1. Name of Institution 2. Name of Qualification 3. Have you already applied at the institution? Yes No 4. Have you applied for or been granted any other bursary or loan for next year? Yes No If yes, describe below the nature of the financial assistance and any obligations involved and provide the name of the institution that provide the bursary. SECTION E- PARENT (S) / GUARDIAN (S) / NEXT OF KIN INFORMATION 1. Surname 2. First names 3. Identity No. 4. Relationship Mother Father Other, specify 5. Residential Address 6. Postal Address 7. Contact telephone Numbers Home Cellular Work Other Contacts 8. Email address 9. Profession 10. Annual salary (attach copy of salary advice) NB: Attach copies of ID and an affidavit if Parent(s)/ Guardian(s) not working. SECTION - F Please tell us why you have chosen this degree/diploma and how you intend to use it after graduation? What contribution do you feel you would be able to make to Johannesburg Water? SECTION G - DECLARATION I hereby confirm that the above information is true and correct. Signature of Applicant: ________________________________ date_____________________ Signature of Parent/ Legal Guardian: _
Posted on: Tue, 19 Aug 2014 12:41:33 +0000
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