ࡱ> #% !" +bjbj[[ 99!<TTTTT$xxxP|x.$j:#######$%J(H#T"#TT#!!!TT#!#!!%"M" 78^="##0.$E"**M"*TM"LhlJ!<##J!.$* :   SHAPE \* MERGEFORMAT  Faculty of Education Financial Assistance Application Form (Bursary and Hardship Funding Application Form) This form should be used if you are applying for financial assistance from bursary and hardship funds for a programme of study offered by the Faculty of Education at the Royal Academy of Dance. The form should be used to provide details about your financial circumstances so that the RAD can decide if financial assistance can be offered to you. Late submission of the form may prejudice your application. Please note that for part-time programmes, only one application per level will be possible. All students should complete Sections 1 to 8, and Section 11 (as appropriate), and sign the declaration in Section 12. You should then ask your parent(s)/guardian or partner (as appropriate) to fill in Section 9 or 10 and to sign the declaration in section 12. If a section is not applicable to you, please enter N/A. Section 1Personal details to be completed by the studentYour application is for (please tick as appropriate): Bursary supportHardship supportBoth bursary and hardship support Your surname Your first name(s) Your date of birthDateMonthYear Your age at the start of the programme of study in yearsProgramme Applied for or studying  Year of Entry Current Level of Study Student ID numberHave you researched and sought funding from other bodies? Please state which organisations. Have you applied for assistance from the RAD before? Please circleYesNoIf yes when? Are you:Single?(Married/cohabiting?(Divorced?(Separated?(Widowed?( Section 2Dependent children to be completed by the studentIf you have any children who will be wholly or partly dependent on you for the duration of the programme of study for which you have applied, please enter their details below. Continue on a separate sheet if necessary. Full nameDate of birthSchool or establishment to be attendedAnnual gross income of child Section 3Your income to be completed by the studentTo assess your financial status we need you to fill this form in accurately, giving all the details you can. Where appropriate, please specify where from and complete for the most appropriate payment period. Count items once only. Will you be in receipt of any unearned income during the current academic year?Yes(No(If yes, please give details of this income and the amount you expect to receive: (Do not include details of any earnings from part-time employment.) ItemWeek ()Month ()Year() Tuition Fee Loan Maintenance Grant (Please Specify) Student Loan for Living CostsParents Learning Allowance/Lone Parents Grant Adult Dependants Grant Childcare Grant Care Leavers Grant Disabled Students Allowance (DSA) Net Earnings Parental/Partner Contribution Child Tax Credit Working tax Credit Child Benefit Housing/Council Tax Benefit Income Support Jobseekers Allowance Professional/Career Development Loan Other Scholarships/Trusts/Grants Disability benefits (please specify) Other income including savings (please specify) TOTAL INCOME Section 4Your partners income to be completed by the studentPlease give details of your partners income. ItemWeek ()Month ()Year ()Net earnings Other PARTNERS INCOME TOTALS  Section 5Your expenditure to be completed by the studentWill your expenditure be greater than your income during the current academic year?Yes(No(Please give details of your principal expenses and the amount you expect to spend: ItemWeek ()Month ()Year() Food/Household/Laundry Gas Electricity Water Telephone TV Licence Contents insurance Council Tax Fees Rent/Mortgage Childcare costs Travel costs (home to institution) Travel costs (daily travel during term time) Private vehicle costs (road tax/fuel/insurance/maintenance etc) Books/equipment/course costs (including photocopying) Disability costs not covered by DSA (please specify) Insurance (excluding car/contents insurance) Other costs (please specify)TOTAL EXPENDITURE Section 6Financial Request to be completed by the student Total Annual Income (from sections 3 and 4)  Total Annual Expenditure (from section 5)  The difference between these values:  How much support are you applying for?  Hardship Fund  Bursary Fund  Which Bursary are you applying to?General Bursary Fund (Professor Kasza-Kasser Memorial Fund (Bursary) (Margot Fonteyn Bursary Fund (Dame Beryl Grey Fund (Bursary)(Violet Binnie Bequest (Bursary)(  Have you read and understood the Hardship and Bursary Funding policy? ( Section 7Personal Statement to be completed by the studentPlease state why you require financial assistance, and why you believe your situation to be exceptional and to merit additional support. You should also clearly state your career aims or aspirations and how the programme you are studying will fulfil these. You may need to continue on another sheet. Section 8Details of independent student status or parent(s) to be completed by the studentIf you fall into one of the following groups, you will be regarded as an Independent Student and you do not need to provide details of your parents income. If you wish to claim independent status, please indicate which group you fall into by crossing the box next to that group. You will be 25 years of age or over at the beginning of the programme of study applied for or at the beginning of the current academic year of study.(You have been married for two years or more at the beginning of the programme of study applied for.(You have been supporting yourself financially for three years or more by the beginning of the programme of study applied for.(You have no parents living. (Married independent students must give details of their husband/wife and their income. For students aged 25 or over living with their partner, details of partners income must be given. Section 9Details of parents income (dependent students only) to be completed by the students parent(s) with whom the student normally lives. Please indicate in which of the following bands your combined income falls for the financial year ending 5 April prior to the academic year for which application is being made. If divorced or separated, include only your own total income. Below 20,000(20001-24999(25000-29999(30000-34999(35000-39999(40000-44999(45000-49999(50000 or more( Section 10Details of income for partner to be completed by partner Please indicate in which of the following bands your income falls for the financial year ending 5 April prior to the academic year for which application is being made. Below 20,000(20001-24999(25000-29999(30000-34999(35000-39999(40000-44999(45000-49999(50000 or more( Section 11Bank/Building Society details to be completed by the student (Applications for Hardship Funding only)You need to supply us with your Bank/Building Society details if your application for hardship funding is successful we will use these to pay funds to you. Name of Bank/Building Society Branch name Sort Code Account name Account number Section 12Declaration to be signed by the student and his/her parent(s) or spouse or partner I declare that the information given in this form is, to the best of my knowledge, information and belief, true and accurate in all respects. I understand that if financial assistance is offered, this will be conditional upon confirmation of the above information. The income figures and confirmation of independent status (where appropriate) may be subject to verification. Signature of Student DateSignature of Parent/Partner* Date*Delete as appropriate Please complete and return this form to: Registrar (Financial Support) Faculty of Education Royal Academy of Dance 36 Battersea Square LONDON SW11 3RA Confidentiality Applications for assistance will only be shared with appropriate members of RAD staff those involved in making the decision on funding. It may be necessary for those making the decision to share or seek information from other colleagues. Your Bank/Building Society details will be passed to the Finance Department in order to make payment in case hardship funding is awarded.     CONFIDENTIAL  FILENAME \p S:\Faculty of Education\09 Quality Assurance\Policies and Procedures\Policies and Procedures for 2018-19\Hardship and Bursary Funding Policy\2. Financial Assistance Application Form (Bursary and Hardship Fund).doc  PAGE 7 of  NUMPAGES 8 February 2011   #$%'(?Se 2 ЬÚyga[UF:Fh[CJOJQJ^JhSh",CJOJQJ^J h",CJ hSCJ h[CJ#h &h[5CJOJQJ^JaJ#hh[5CJ$OJQJ^JaJ$h[5CJ$OJQJ^JaJ$#hhS5CJ$OJQJ^JaJ$,jhhSOJQJU^JmHnHuhhSOJQJ^J!jhhSOJQJU^JhSCJOJQJ^JaJ hhSCJOJQJ^JaJ   ()>?e3 4  9r $a$gd[$a$gdS2 3 4    , 4 d e i k  ;|ͲlZl"hSh",56CJOJQJ^JhSh",5CJOJQJ^JhlCJOJQJ^JhSh? ^CJOJQJ^Jh h",CJOJQJ^Jh? ^CJOJQJ^Jh;cCJOJQJ^JhSh",CJOJQJ^Jh CJOJQJ^JhX,hC~&CJOJQJ^JhC~&CJOJQJ^Jh",CJOJQJ^J   F _kd$$Ifl0 I %%0M!4 lap%%yt"+  9r $If 9r  & ( B E G H W Y Z [ k m n o 2 ? 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