<p> THE KANTEY & TEMPLER</p><p>BURSARY AND EDUCATIONAL ASSISTANCE SCHEME</p><p>APPLICATION FOR FINANCIAL ASSISTANCE</p><p>NOTE: This application must be completed in BLOCK CAPITALS and submitted to the Bursary Committee no later than 30 September in the year prior to that for which assistance is sought.</p><p>APPLICANT’S DETAILS : Date of Birth:</p><p>Full Name: Gender:</p><p>ID No.: </p><p>Home Address: Home Language:</p><p>Postal Address (if different from home address): Telephone No.:</p><p>If applicable, show here the full name of Parent or Guardian who is (or was) a full time permanent employee of Kantey & Templer:</p><p>If such a Parent or Guardian is currently employed by Kantey & Templer, indicate in what Department/Office. </p><p>EDUCATIONAL INFORMATION:</p><p>Level Name of school or Highest level Educational establishment attended achieved</p><p>Secondary</p><p>University of Technology - 2 -</p><p>EDUCATIONAL INFORMATION:</p><p>Level Name of school or Highest level Educational establishment attended achieved</p><p>University</p><p>Give details of any distinctions (academic or sport) gained so far during schooling (eg monitor, prefect, head of house, member of 1st, 2nd team, etc)</p><p>Where Details of Distinctions, etc</p><p>At Secondary School</p><p>At Technical College or University</p><p>OTHER PERSONAL INFORMATION:</p><p>Sports played at present:</p><p>Hobbies and other interests:</p><p>Any other personal information, career plans and the like which in your view should be considered in support of this application:</p><p>DETAILS OF BURSARY BEING SOUGHT:</p><p>For which Engineering course: </p><p>For which University or University of Technology:</p><p>For which academic year: For which calendar year:</p><p>Estimated Tuition Fees for the year quoted above: R</p><p>This Application is a New Application ...... } tick Renewal ...... } as appropriate - 3 -</p><p>DETAILS OF ANY OTHER BURSARY OR SCHOLARSHIP RECEIVED:</p><p>Granted By ? For What ? Value of Award ?</p><p>PROVIDE ANY OTHER INFORMATION YOU BELIEVE WOULD ENHANCE YOUR APPLICATION</p><p>ATTACH COPIES OF LATEST AVAILABLE ACADEMIC RESULTS TO THIS FORM e.g. Std 9, Std 10 mid year and/or Std 10 (Senior Certificate) results. First semester and/or year end University or University of Technology results.</p><p>SIGNATURE OF APPLICANT:</p><p>DATE ...... </p><p>DECISION OF THE BURSARY COMMITTEE AND REASONS FOR THAT DECISION:</p><p>D:\Docs\2018-04-04\00bbda480985cafcf0c730421d746e15.doc Last updated: 07/05/2015</p>