BURSARY APPLICATION FORM: FUNDING

ASSISTANCE FOR THE 2020 ACADEMIC YEAR

Please use a black pen.

Mark with X to indicate your status.
Currently in Grade 12
Matriculated within the last 2 years but taking a gap year
Currently studying at a South African Public University
Currently studying at a South African Public University of Technology

IMPORTANT TO NOTE:
1. The Nedbank Bursary cannot be used to pay for existing loans or debts.
2. Funding is applicable for the 2020 academic year only.
3. Bursaries are given at the sole discretion of Nedbank Education Trust. Any decision to award a bursary will be final and
Nedbank will not enter into further communication with applicants who were not successful.
4. All applications must reach the Bursary office by 30 September 2019 and no late applications will be considered.
5. If you have not heard from us by the end of the year, please accept that your application was unsuccessful.
6. The bursary is applicable only for undergraduate studies at a South African Public University or University of Technology.
7. Applicants will be considered according to academic performance and financial need as determined by a financial needs test.
8. Application forms that are not signed, incomplete or incorrect will not be considered.

ELIGIBILITY CRITERIA:
To be considered as an applicant for the Nedbank Education bursary, you must meet the following criteria:
– Be a South African citizen;
– Be in grade 12 or have completed grade 12 within the past two years;
– Have passed matric with a minimum average of 65%;
– Meet the entry requirements for the qualification and university you want to study at; and
– Complete all sections, sign and date this application form.

SECTION 1 – PERSONAL DETAILS OF APPLICANT (Please complete this form in block capital letters.)

Full name(s)

Surname

SA ID number (note only applications from SA citizens will be considered)

Date of birth

Gender Male Female

Race African Indian Coloured White

Address whilst studying (if currently at University)

Home address Postal code

Postal address Postal code

Email address

Home telephone number Cell number

Disability? Yes No

If ‘Yes’, describe the nature of the disability:

Have you ever been found guilty of a criminal offence? Yes No

If ‘Yes’, please specify the date and nature of the offence:

Page 1 of 6
SECTION 2 – PARENT/GUARDIAN INFORMATION

FATHER MOTHER

Name Name

Surname Surname

ID number ID number

Cell number Cell number

Work number Work number

Home number Home number

Email address Email address

Home address Home address

Job title Job title

Employer Employer

* PLEASE PROVIDE GUARDIAN’S DETAILS SHOULD EITHER PARENT’S DETAILS NOT BE AVAILABLE.

SECTION 3 – HIGH SCHOOL INFORMATION

Name of school

Type of school Public Private

How were your studies funded?

School address

School telephone number

GRADE 12 RESULTS (GRADE 11, IF CURRENTLY IN MATRIC):

Subject Final percentage obtained

Total average percentage

Page 2 of 6
SECTION 4 – TERTIARY INSTITUTION INFORMATION

Name of University (current/intended)

Qualification (current/intended)

Year of study – Not yet started / 1st / 2nd / 3rd

Major subjects for degree

LATEST ACADEMIC RESULTS:

Module Results

Total average percentage

Where did you hear about the Nedbank Bursary?

Have you applied for any other bursary? Yes No

If yes, specify the name of the company

Was your application successful?

If yes, please provide details of the nature of assistance and any obligations involved?

If studying towards a degree, how have your studies been funded to date?

Page 3 of 6
SECTION 5 – DETAILS ABOUT PARENT(S) / GUARDIAN(S) INCOME & HOUSEHOLD EXPENSES

PARENT 1 / GUARDIAN 1
Income
Gross Monthly Income (Income before tax and UIF) R
Less: Monthly Income tax and UIF R
Other income R
Description
Other Income R
Description
Total Income after Tax and UIF R

PARENT 2 / GUARDIAN 2
Income
Gross Monthly Income (Income before tax and UIF) R
Less: Monthly Income tax and UIF R
Other income R
Description
Other Income R
Description
Total Income after Tax and UIF R

Total Household Expenses Details

Medical aid R
Other monthly medical expenses R
Food and Groceries R
Transport/Fuel R
School/University/Education fees R
Telephone/Cell phone/Internet R
Subscriptions (eg DSTV, TV Licence) R
Life cover/Funeral plans/Provident fund R
Investment policies/Products R
Water, electricity, rates and taxes and levies R
Entertainment R
Bond/Rent R
Domestic helper R
Child support/Maintenance R
Gym/Club membership R
Other expenses R
Other expenses R
Total Monthly Expenses R

Number of dependents in the household:

Please specify relationship to applicant ie parents/ guardians/ siblings/ grandparents:

Page 4 of 6
SECTION 6 – SUPPORTING DOCUMENTATION

Certified copies of the following documents have been attached to this application (mark with X):

Identity document
Grade 11 year-end results (if currently in Matric)
Matric Certificate (if currently at University or taking a gap year/s)
Latest University results (if currently at University)

SECTION 7 – DECLARATION

I hereby declare that all the information provided in this application form is complete and correct.

I hereby acknowledge that if any of the information provided in this application form is found to be incomplete and/or incorrect,
my application will be disqualified.

I give Nedbank Pty Ltd permission to validate the information I have provided with third parties.

To process your application, Nedbank requires the above information as requested in the application form, some of which might
fall within the definition of Personal Information as defined in the Protection of Personal Information Act of 2013.

Applicant signature:

Parent/guardian signature: (if applicant under the age of 18)

Date:

Please return your completed application form to:

EMAIL: unlockyourambition@nedbank.co.za

POST/ DELIVER:
ATTENTION: NEDBANK EXTERNAL BURSARY DEPARTMENT
Group Human Resources
Nedbank 135 Rivonia Road
E Block, 5th Floor
Sandton
2000

Page 5 of 6
SECTION 8 – MOTIVATION

Applicant Name:

Applicant Surname:

Should you be successful in being awarded the bursary, why would you be the ideal Nedbank Brand Ambassador as an external
bursary holder?

purpleberry 0619/10999

Page 6 of 6