Benn Bursary Application Form Michaelmas Term 2017

Matriculation 2017

Benn Bursary Application Form – Michaelmas Term 2017

Completed applications should be submitted to the Tutorial Registrar, Rosie Ince, either by email to [email protected], or via the Tutorial Office pigeonhole.

The deadline for submission is 5pm on Wednesday 15 November 2017. Forms will not be accepted if the Tutor’s comments section has not been completed. Please be sure to include confirmation of your fees and maintenance loans/grants from the Student Loans Company (a screenshot of your online account is acceptable).

Section A – Overview

First Name: Last Name: CRSid: Matric Year: Subject: Year of Study: 1st / 2nd / 3rd / 4th Tutor: Fees Classification: Home / EU / Overseas

Reason for Application: (Please explain why you are applying for a Benn Bursary, including details of any unforeseen changes in your financial circumstances, e.g. a fall in income, or unexpected additional expenditure that could not reasonably have been foreseen)

Total Expenditure for the Term: (from Section B: Expenditure) £

Total Income for the Term: (from Section B: Income) £

Balance: (Income – Expenditure) £ Would you like a JCR Welfare Officer to be present when your application is considered? Yes / No (Delete as applicable – non-completion will be considered a ‘yes’) Have you applied for/received support from either of the following funds: Cambridge Bursary Scheme Yes / No Outcome: Bell, Abbott and Barnes Fund Yes / No Outcome: If you have not applied to either of these funds, please briefly explain why:

Student’s Signature: Date: Matriculation 2017 Section B – Income & Expenditure

Expenditure Costs for the Term Notional Actual Notes Tuition fees £2,312.50 Michaelmas Term instalment College fees £0 Zero for most UK/EU students Rent This is the median rent for TH undergraduates £1,381 (see guidance notes) Council Tax £0 Should be zero (see guidance notes) Interest payments on loans and credit cards This entry will be considered only in exceptional circumstances, relating to a debt incurred in a £0 previous term for which a Benn application was not lodged Utility costs (e.g. gas and electricity) £10 Food: Kitchen Fixed Charge £200 Put lower figure if you do not live on Central Site Food: meal cost Change this figure if you have a special diet for £450 religious or medical reasons Medical expenses and costs arising from disabilities £40 Contact lenses, glasses, prescriptions etc. Laundry £54 Course books and equipment £70 Travel as part of course and placement costs £0 Clothing £70 Sundries £65 Toiletries, insurance etc. Entertainment £200 Going out, mobile phone, clubs/societies etc. Sport/music/drama performed at College or £0 University level Travel at the start and end of term The cost of travel to your parents/guardians £0 home Other expenses £0 TOTAL COSTS FOR THE TERM £4,852.50 £

COSTS FOR THE PREVIOUS VACATION Notional Actual Notes Rent College: Put down actual cost £0 Private: if you have rented accommodation for a year, this is included in line 3. Food £0 Other expenses £0 TOTAL COSTS FOR VACATION £0.00 £

TOTAL EXPENDITURE (TERM + VACATION) £4,852.50 £ Matriculation 2017 Income Income for the Term Amount Notes State contribution to: Fees Loan Please see note below Maintenance Loan

Maintenance Grant Support and gifts from family and other sources Please see note below Cambridge Bursary 1/3 of the total bursary Other University/external bursaries and grants 1/3 of the income for the year Income from employment during previous vacation Other income e.g. savings TOTAL INCOME FOR THE TERM AND PREVIOUS £ VACATION Notes on income:  State contribution: please check your Student Finance letter/online account for these amounts.  Support and gifts from family and other sources: Please show all support for the term. The College assumes support so that the total income from the state contribution and family support combined is at least £4,500. If your income does not reach this level, please explain why you are not getting the parental/guardian contribution that is expected.  Other bursaries and grants: If you have applied for another bursary or grant and don’t yet know the outcome of your application, please put £0 in the income section but note that you have applied.