This form should be used if you are apply for financial ...



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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 1 |Personal details to be completed by the student |

|Your application is for (please tick as appropriate): |

| |Bursary support | |

| |Hardship support | |

| |Both bursary and hardship support | |

| | |

|Your surname | |

| | |

|Your first name(s) | |

| |Date | |Month | |Year | |

|Your date of birth | | | | | | |

| | |

|Your age at the start of the programme of study in years | |

|Programme Applied for or studying | |

| | |

|Year of Entry | |

| | |

|Current Level of Study | |

| | |

|Student ID number | |

|Have you researched and sought funding | |

|from other bodies? Please state which | |

|organisations. | |

| | |

| | |

| | |

| | |

| | |

| | |

|Have you applied for assistance from the RAD before? Please circle |Yes |No |

|If yes – when? | |

|Are you: |

|Single? |( |Married/cohabiting? |( |Divorced? |( |

|Separated? |( |Widowed? |( | |

|Section 2 |Dependent children to be completed by the student |

If 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 name |Date of birth |School or establishment to be |Annual gross income of child |

| | |attended | |

| | | | |

| | | | |

| | | | |

| | | | |

| | | | |

|Section 3 |Your income to be completed by the student |

To 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 |Yes |( |No |( |

|current academic year? | | | | |

|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.) |

|Item |Week (£) |Month (£) |Year(£) |

| | | | |

|Tuition Fee Loan | | | |

| | | | |

|Maintenance Grant (Please Specify) | | | |

| | | | |

|Student Loan for Living Costs | | | |

|Parents Learning Allowance/Lone Parent’s 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 4 |Your partner’s income to be completed by the student |

Please give details of your partner’s income.

|Item |Week (£) |Month (£) |Year (£) |

|Net earnings | | | |

|Other | | | |

|PARTNER’S INCOME TOTALS | | | |

|Section 5 |Your expenditure to be completed by the student |

|Will your expenditure be greater than your income during the current |Yes |( |No |( |

|academic year? | | | | |

|Please give details of your principal expenses and the amount you expect to spend: |

|Item |Week (£) |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 6 |Financial 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 | |Margot Fonteyn Bursary Fund | |

| |( |Fund (Bursary) |( | |( |

|Dame Beryl Grey Fund (Bursary) |( |Violet Binnie Bequest (Bursary) |( | |

| | |

|Have you read and understood the Hardship and Bursary Funding policy? |( |

|Section 7 |Personal Statement to be completed by the student |

Please 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 8 |Details of independent student status or parent(s) to be completed by the student |

If 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 partner’s income must be given.

|Section 9 |Details of parents’ income (dependent students only) to be completed by the student’s 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 10 |Details 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 11 |Bank/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 12 |Declaration 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 | |Date | |

|Signature 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.

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