INTERNATIONAL SUMMER MUSIC ACADEMY

BURSARY APPLICATION FORM 2014

ALL APPLICANTS FOR FINANCIAL ASSISTANCE MUST COMPLETE THIS FORM IN ITS
ENTIRETY. UNANSWERED PORTIONS AND/OR ABSENCE OF PROPER SIGNATURES WILL
CONSTITUTE AN INCOMPLETE APPLICATION AND WILL DISQUALIFY THE APPLICANT
FROM CONSIDERATION. INFORMATION WILL BE HELD IN STRICT CONFIDENCE.

APPLICANTS INFORMATION
FIRST NAME(S) _________________________________________________
_________________________________________________

LAST NAME:

POSTCODE/ZIP CODE___________________________________________
NATIONALITY________________________________________________
PRINCIPAL INSTRUMENT_________________________________________ SECONDARY
INSTRUMENT(S)__________________________________
ENSEMBLE NAME (if applying as pre-formed group) _________________________________________________

FINANCIAL ASSISTANCE
PLEASE TICK CURRENT EDUCATIONAL LEVEL
School

Undergraduate

Postgraduate

Young professional

Are you the recipient of any educational funds (family support, scholarship, grant award, or prize) from a country, organisation or
individual specifically for your current course of educational study?
Yes

No

If Yes please give details (including those pending).

Awarding body

Amount awarded

Date awarded/
Expected date of answer

Purpose of grant & dates covered

Have you applied for or received any educational funds (family support, scholarship, grant award, or prize)
which can contribute towards your attendance at Lake District Summer Music during 2014?
Yes

No

If Yes please give details (including those pending).

Awarding body

Amount awarded

Date awarded/
Expected date of answer

Purpose of grant & dates covered

How much financial aid towards course fees would you need to come to Lake District Summer Music? ______________
(Please note that if you are offered a bursary, it may not be for the full amount you ask for)
Lake District Summer Music, Stricklandgate House, Kendal, Cumbria. LA9 4PU Tel: 00 44 1539 742620 E: courses@ldsm.org.uk

YOUR CURRENT FINANCES

Please answer the following questions in relation to the 12 months from September 2012 to August 2013

Income

Expenditure

Earnings from:
Performances
Teaching
Other employment (list below)

Travel
Food & accommodation
Entertainment
Education Fees:
Education institution
Private lessons/consultations

Scholarships
Other special awards (e.g. grants)

Instrument (including bow if applicable)

Purchase
Hire
Repairs
Insurance
Income Tax

Competition Prizes
Other (please list)

Other (please list)

TOTAL (income)

TOTAL (expenditure)

Assets

Liabilities

Cash in hand or at bank

Local Education Authority:

The Student Loans Company:
College or University:
Bank:
Credit Card:
Other (please specify)

Instrument insurance value

Other (please list)

FINANCIAL INDEPENDENCE
1. Are you over 18 years of age?
2. Are you a post-graduate student? Yes

Yes

No

No

Lake District Summer Music, Stricklandgate House, Kendal, Cumbria. LA9 4PU Tel: 00 44 1539 742620 E: courses@ldsm.org.uk

3. Are you supporting any dependents (i.e. children, elderly parent)?

Yes

No

If you have answered Yes to one or more of the above questions, you may claim yourself financially independent.
If you have answered No to all the above questions answer questions 4 & 5.

4. Did you live in your parents home for six consecutive weeks or more in the past year? Yes
No
5. Have you received more than 2,000 assistance from your parents in the past year? (including clothing, medical care,
insurance etc.)
Yes
No
If you have answered No to both questions 4 & 5, above, then you may claim yourself financially independent.
If you have answered Yes to one or more of the above questions, you must ask your parents to submit the required
financial data below.

IF NOT FINANCIALLY INDEPENDENT PLEASE ASK YOUR PARENTS/GUARDIAN TO COMPLETE THE FOLLOWING:
2012/2013 Financial Year Gross Income
Other Information
Father / Male Guardian
Mother / Female Guardian

EMPLOYER:
POSITION:
CONTACT TELEPHONE No:
EMPLOYER:
POSITION:
CONTACT TELEPHONE No:

Father/Male Guardians signature: _________________________________________________

Date:_________________
(postal applications)

Mother/Female Guardians signature:_______________________________________________

Date:_________________
(postal applications)

ALL STUDENTS

MUST PROVIDE AN INDEPENDENT FINANCIAL REFEREE (not a relative. This could be principal, head, bursar, instrumental teacher,

other funding body)

NAME:____________________________________________________
_
ADDRESS: ____________________________________________________
_______________________________________________________________________________________________________
___________
CONTACT TELEPHONE NUMBER:____________________________________
EMAIL: _________________________________________________________
RELATIONSHIP OF REFEREE TO
YOU:____________________________________________________________________________

FOR CONSIDERATION PLEASE RETURN THIS FORM TO US BY 31 MAY 2014

PLEASE NOTE that this application cannot be considered until the application form, registration fee,
digital photograph, CV and additional information have been submitted.
Additional Information may be sent as attachments to courses@ldsm.org.uk or, if sending by post, attached on a separate sheet which must be stapled to this form
LDSM, .Stricklandgate House, Kendal, Cumbria LA9 4PU, UK

Lake District Summer Music, Stricklandgate House, Kendal, Cumbria. LA9 4PU Tel: 00 44 1539 742620 E: courses@ldsm.org.uk