Bursary- College Meals/Transport/Application Form

BURSARY- COLLEGE MEALS/TRANSPORT/APPLICATION FORM Academic Year 2017/2018

Please Note The Following Important Information  You should read the 16-19 Bursary Fund Guideline 2017/2018 to make sure you are eligible to apply.  Please complete all sections of the form and make sure you provide us with the Official letters of evidence we need. Your application will not be assessed without the correct evidence.  If your Household income is £20,000 you will be entitled to a bursary.  The budget we have available is limited so we cannot guarantee that we will be able to provide you with the financial support you request.  All bursaries are dependent on you maintaining attendance of 92% or above on all your courses and behaving appropriately in College. Attendance will be checked.

When you have completed this form please return it, fully completed with evidence, to the Student Services.

SECTION 1: PERSONAL DETAILS

Surname First name

DD/MM/YYYY Mobile No. Date of Birth

Address

Postcode Phone (home)

SECTION 2: RESIDENCY

Please select which of the following applies to you: British Citizen  EU / EEA Citizen  Asylum Seeker  Refugee  Indefinite Leave to Remain  Other (please specify) Have you been resident in the UK or EU/EEA for the last 3 years? Yes  No 

SECTION 3: GUARANTEED BURSARY

Are you (the student): Please only tick a box if you are answering “yes” In Care  A Care Leaver?  In receipt of Income Support  (Letter from Local Authority confirming looked after status (if applicable). In receipt of Employment Support Allowance and Disability Living Allowance or Personal Independence Payment  (Please provide official evidence of benefit / allowance).

If you have ticked any of the boxes above please go straight to the last page.

D:\Docs\2018-05-09\0cb2724115c545414edc1562b6d42e30.docx BURSARY- COLLEGE MEALS/TRANSPORT/APPLICATION FORM Academic Year 2017/2018

SECTION 4: DISCRETIONARY BURSARY (you only have to provide evidence for one of the target groups but please answer all questions)

TARGET GROUP 1 – FREE COLLEGE MEALS

Were you eligible to receive free school meals in Year 11: Yes  No  (You will need to show the official letter). Evidence seen 

Free school meals for your son/daughter are available if you are receiving one of the following qualifying benefits and it does not exceed £16,190:

 Income Support (IS)   Income Based Jobseekers Allowance (IBJSA);   An income-related Employment and Support Allowance;   Support under part VI of the Immigration and Asylum Act 1999   Child Tax Credit;   The Guarantee element of State Pension Credit;   Students who receive Income Support or Income Based Jobseekers Allowance in their own  right are also entitled to receive Free School Meals. Evidence seen 

TARGET GROUP 2 – BENEFITS

(If you live with your Parents/Guardian/Carer/Partner we need full details of the HOUSEHOLD INCOME and can only make an assessment once all has been supplied). All evidence from benefits must be the Official Award Notice that was issued at the time the benefit was issued – We do not accept bank statements as evidence.

Are you, or your parent(s)/carer(s), in receipt of one or more of the following benefits: IS (Income Support) or Universal Credit (a new benefit which will replace Income  Support) ESA (Employment Support Allowance  DLA (Disability Living Allowance)  Personal Independence Payments  Working Tax Credits  Child Tax Credits  ALG (Adult Learning Grant)  JSA (Job Seekers Allowance)  Maintenance/Child Support  Other – please state: 

Evidence seen 

TARGET GROUP 3 - INCOME Are you, or your parent(s)/Carer(s) not in receipt of one of the benefits listed above but are employed or self-employed with a gross household income less than £20,000 – Evidence required wage slips – P60 Yes  No  Evidence seen 

TARGET GROUP 4 – YOUNG PARENTS BURSARY- COLLEGE MEALS/TRANSPORT/APPLICATION FORM Academic Year 2017/2018

Are you a young parent? Yes  No  Please supply birth certificate of child/(ren) Evidence seen 

SECTION 5: TRANSPORT I live more than 3 miles away from College and would like to apply for help with my travel costs. (only in certain circumstances will we help with travel costs if you live less than three miles from college). Yes  No 

There may be other costs which occur throughout the year e.g., College trips, exams re-sits or travel to university visits. We appreciate that you may not know these costs at the time of completing this application so at present we will only consider support in relation to the questions asked above. If you have other College-related costs in the future then you will need to contact Student Services. You can either drop in to the Student Services Centre or email us at [email protected].

SECTION 6: STUDENT & PARENT/CARER DECLARATION This declaration must be signed by all students. If the income evidence provided belongs to parent(s)/Carer(s) then we must also have a parent/Carer signature.

I/we certify that the information given is, to the best of my/our knowledge and belief correct.

I/we understand that that the bursary will be stopped if I do not maintain the minimum College requirement of at least 90% attendance on all my courses.

I/we undertake to inform the College immediately if I, the applicant, decide to leave my course.

I/we understand that the information provided on this application may be shared with other departments in College.

Student’s Signature ………………………………………………………………….. Date: / /

Parent/Carer Signature ……………………………………………………………… Date: / /

Data Protection Statement – Barrow Sixth Form College wishes to fully observe the Data Protection Act 1998 and requires your consent to process your application using the data you have provided. Please note that by signing this form you are giving explicit consent for the data collected to be stored / processed.

BANK ACCOUNT DETAILS (must be in the applicant’s name ONLY)

Name of Account Holder (as shown on statement) Account Number

Sort Code

Name and Address of Bank

OFFICE USE ONLY

DECISION MADE

AWARDED:  DECLINED 

DATE DECISION LETTER SENT

D:\Docs\2018-05-09\0cb2724115c545414edc1562b6d42e30.docx