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TO BE COMPLETED BY ALL APPLICANTS

Applicant Personal Details:

Title (required):

Name (required):

Referee (required):

DOB (required):

House number/name (required):

Street (required):

Town (required):

City (required):

Postcode (required):

Term Address (required):

Email (required):

Phone (required):

SUPPORTING PAPERWORK (Required):

Bank Account Details

(to enable the Governors to issue grants if you are successful)

Name on Account (required):

Sort Code (required):

Account Number (required):

Are you applying as a current or future undergraduate or postgraduate at university/college?

YesNo

If yes, please complete all the fields below.

University/College Details:

Course Details:

Duration of complete course. Add a start and finish date (month/year)

Duration:

Full or Part-time:

Have you claimed for maintenance loan from Student Finance, if so, how much?

Loan Amount:

Have you claimed the maximum maintenance loan you are allowed to? How much is this?

Loan Limit:

Have you got a full/part time job whilst studying? If yes, how much do you earn per month?

Employment:

How much money do you require to undertake the course?

Financial Requirements:

What is your own contribution towards the costs?

Contribution:

How much are you applying for from the Foundation?

Application Value:

Is there any other funding you could apply for and have you applied for it?

Alternative Funding:

IMPORTANT - Send proof you are either currently on the course, enrolled on the course or have received a conditional offer or unconditional offer. If you are on the course, you will need to submit a reference from one of your tutors.

If no, please complete all the fields below

How much money do you need and what do you need it for?

Details:

Do you have any funding/part funding in place already? If yes please provide details.

Details:

What is your own or family contribution?

Details:

Is there any other funding you could apply for and have you applied for it?

Details:

Monthly Income (£):

Monthly Expenditure (£):

IMPORTANT - Send evidence to support your application for example quotes, costings, website pages or proof you have been accepted on a trip or event.

TO BE COMPLETED BY ALL APPLICANTS

Brief background information and reasons for applying to the Foundation

Qualifications/recent employment history if applicable

Employment History (required):

Reasons for applying – please give your reasons for applying to the Foundation for assistance (no more than 500 words) (required).

Details (required):

YOUR ATTENTION IS DRAWN TO THE PRIVACY NOTICE BELOW

Your signature on and submission of this form are your confirmation that all of the information provided by you to the Foundation in relation to its grant making activity is correct, complete, true and accurate in all respects.

Your signature on and submission of this form also confirms that you have read and acknowledge this form and your consent to the Foundation using any sensitive personal data pertaining to you and other individuals in accordance with the privacy notice below. You confirm that you have as far as is necessary complied with the requirements under the heading 'Personal information about individuals other than the provider of the information' set out below.

Signed (required):

Date (required):

Print name (required):

The Foundation may disclose grant applications and information otherwise provided, in whole or part, to selected other charities who may be able to consider providing grant support. If you do not agree to such information being disclosed please tick the following box:

I Disagree

Where personal data is provided in relation to a person under 16 years of age, consent must also be provided by their parent or legal guardian.

Parent/Guardian Name:

Date:

Aims of the

Foundation

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The Foundation's income is applied in the following ways:

(a) in awarding beneficiaries scholarships bursaries or maintenance allowances tenable at any school, university or other place of learning approved by the Governors;

(b) in providing financial assistance, outfits, clothing, tools, instruments or books to enable beneficiaries on leaving school or university or any other educational establishment to prepare for or to assist their entry into a professional trade or calling;

(c) in awarding scholarships or maintenance allowances to enable beneficiaries to travel abroad to pursue their education;

(d) in providing or assisting in the provision of facilities of any kind not normally provided by the Local Education Authority for recreation, social and physical training including the provision of coaching in athletics, sport and games for beneficiaries who are receiving primary, secondary or further education;

(e) in providing financial assistance to enable beneficiaries to study music or other arts.

Beneficiaries means persons resident in the City of Sheffield who, in the opinion of the Governors, are in need of financial assistance.

Please note: Grants are awarded using the above aims but at the discretion of the Governors