<p> The TCD Association and Trust provides grant support for a wide variety of Student Societies, Staff and College projects where funding is not available from mainstream resources, contributing significantly to, and enriching, the life of the College. One of the main sources of funding for the TCD Association and Trust comes from the TCD Affinity Credit Card. With over 10,000 cardholders to date, a percentage of the annual turnover on these cards is donated back to College by Bank of Ireland.</p><p>TRINITY TRUST UNDERGRADUATE PLACEMENT GRANT</p><p>SECTION A – Student Information</p><p>Student Number: Date of Birth:</p><p>Firstname: PPS:</p><p>Surname: Telephone:</p><p>College Email: Year:</p><p>Term Address:</p><p>SECTION B – Placement Information</p><p>Department/School:</p><p>Lecturer Name:</p><p>Placement venue/hospital:</p><p>Dates & Duration of placement: Approximate Distance of placement from TCD? Additional expenses due to Placement (These are ADDITIONAL EXPENSES ONLY – if your placement is costing more than it usually costs to get to College, then you can claim the additional expense only.). RECEIPTS MUST BE PROVIDED FOR DATES CLAIMED FOR – NO FUNDING WILL BE ISSUED WITHOUT BACKUP RECEIPTS. Type Cost Weekly (provide receipts) Other Funding Received Travel Expenses to Placement € Travel Expenses to College € Accommodation expenses –(only if you € have to rent additional accommodation due to where your placement is located) Other expenses, not covered € Please specify below: 1. 2. 3. 4. TOTAL FUNDING YOU ARE APPLYING FOR: € (Please specify the total amount of funding you are applying for) SECTION C – Financial Information</p><p>Please specify yes/no below Yes No If ‘yes’ please specify the amount in € that you receive Amount Have you applied for & been granted financial assistance from TCD this year or in previous years? Are you in receipt of Local Authority Grant? Are you in receipt of Social Welfare Payments? Are you in receipt of Department of Health Funding for placement? Are you sponsored by the Public Health Service Employee Scheme? </p><p>Please give MONTHLY income in euros below:</p><p>Monthly Income Self? If under 23, Monthly income for mother/guardian (incl. Social Welfare payments) If under 23, Monthly income for father/guardian (incl. Social Welfare payments) Monthly income for Spouse/Partner (including social welfare payments)</p><p>The following documentation must be provided:</p><p>1. P60 & P21 for applicant for 2013</p><p>2. P60 & P21 for parents/guardians/spouse for 2013</p><p>3. Social Welfare payment statements/advice/payment receipt</p><p>4. Receipts for rent, travel and all other expenses being claimed for.</p><p>You can request your P21 online using the PAYE Anytime service or http://www.revenue.ie/en/personal/p21-balancing-statement.html</p><p>I declare all the above particulars in this application are in every respect true to the best of my judgement and belief</p><p>Student Signature: ______Date: ______</p><p>This application form must be signed off by the Allocations Officer, Tutor, Course Co-ordinator or TCD staff member directly organising your placement.</p><p>I hereby confirm that the above named student is required to attend the placement to which this application refers and that the cost quoted is correct.</p><p>Staff Name: ______Department: ______</p><p>Ext: ______Email: ______</p><p>Applications for Grants are assessed on Financial Hardship, therefore all relevant backup documentation must be provided. Placement support must be applied for in advance of the placement. Applicants who qualify will normally receive assistance AFTER they have completed their placements. Full expenses are not reimbursed.</p><p>Applications for Grants are assessed on Financial Hardship, therefore all relevant backup documentation must be provided.</p>