W&RSETA BURSARY APPLICATION FORM - 2017

NB: Please Complete All Sections of the Application Form in Full.

Applications Received after the closing date (17 February 2017) will not be considered
Applications must be accompanied by supporting documents (refer to section I of the Application form)
Applications must be emailed to: bursaryapplications2017@wrseta.org.za
Were you previously awarded a bursary by W&RSETA Yes No

Have you been accepted at the TVET College or Institution for 2017 academic year Yes No

Have You Matriculated Yes No

Name of High School Yes No

Year Obtained Yes No

A. PERSONAL DETAILS

ID Number

Title Mr Mrs Ms

First Name Initials

Surname

Date of birth Gender Male Female Equity Black Coloured Indian White

Home Language

Nationality

Citizen Residential Status South African Permanent Resident Dual Resident (SA +other)

Socio Economic Status Unemployed Employed

Telephone Number Fax Number:

Cell Phone Number

Email Address

POSTAL ADDRESS PHYSICAL ADDRESS

Postal Address Physical Address

Postal Code Postal Code

District District

Municipality Municipality

Province Province

Is your Area Rural or Urban: Rural Urban

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 B. PARENT OR GUARDIAN DETAILS

ID Number

Title: Mr Mrs Ms Dr Prof Adv

First Name Initials:

Surname

Cell Number Date of Birth

Email Address

Gender Male Female Equity Black Coloured Indian White

Home Language Relationship to Applicant

Nationality

Marital Status Single Married Widowed Divorced

Socio Economic Status Employed Unemployed

C. PARENT OR GUARDIAN EMPLOYER DETAILS

Name of Employer
Employer address

Physical Code Postal Code

D. PARENT OR GUARDIAN INCOME DETAILS

Source of Income: Salary Wages Self Employed Pension Social Grant

Social Grant Number Number of Dependents

Gross Household Income (per month) Disposable Income (per month)

E. STUDY DETAILS

Bursary Application for : TVET College University of Technology University

Have you been accepted: Yes No
F. STUDY DETAILS FOR TVET COLLEGES
(Complete this section if you are accepted or registered at a TVET College)
Name of TVET College :

Name of TVET College Campus

Region (Where the TVET College is located e.g.
Centurion)
Province (Where TVET College is located e.g. Gauteng)

Student Number:

Study Course (e.g. N6 Financial Management)

Field of Study or Discipline (e.g. Financial Management)

Year of Study in 2017 N4 N5 N6 NCV level 2 NCV level 3 NCV level 4

Expected Year of Completing the Studies (e.g. 2018)

Duration of the Qualification 3 Semesters 4 Semesters 3 Years

Qualification Type Nated N6 NCV level 2 NCV level 3 NCV level 4

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 G. STUDY DETAILS FOR UNIVERSITY OF TECHNOLOGY OR UNIVERSITIES (HET)
(Complete this section if you are accepted or registered at a HET)
Name of Institution

Name of Campus

Region (Where the University is located e.g. Pretoria West)

Province (Where the University is located e.g. Gauteng)

Student Number

Study Course

Field of Study or Discipline

Year of Study in 2017 1st Year 2nd Year 3rd Year

Expected Year of Completing the Studies (e.g. 2019)

Duration of the Qualification 3 Years 4 Years

Qualification Type Degree Diploma
H. ACCOMMODATION

Accommodation Status Residing at Home Residing at TVET College / University Accommodation

Are you staying or will you be staying at TVET College/
University residence or Accredited/ Leased/ Contracted student
accommodation: Yes No

If you ticked yes above, Name of Accommodation

I. FEE COST BREAK DOWN

Registration Fee

Tuition Fee (include First and Second Semester fees)

Accommodation if applicable:

Book Allowance

Meal Allowance (Cannot exceed R16 000 per annum)

TOTAL
J. CHECKLIST FOR SUBMISSION OF SUPPORTING DOCUMENTS REQUIRED

(Your application must be accompanied by the following documentation listed below.

Application Forms with incomplete supporting documents will not be considered)

Certified Copy of South African ID

Statement of Results /academic record

Proof of admission or proof of registration

Statement of fees

Proof of accommodation if staying in residence and not reflected on the statement of fees

Proof of Parent or Guardians Income

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 DECLARATION OF AUTHENTICITY

I declare that the information supplied in this application is to the best of my knowledge true and correct.
I understand that any false information will automatically disqualify me from obtaining any funding and
could further lead to me being charged in a Court of Law for fraudulently receiving funding.

Signed at on this day of 2017

Signature

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FOR OFFICE USE ONLY

APPLICATION NO. DATE RECEIVED

APPLICATION REVIEW DATE OUTCOME OF APPLICATION : Accepted Declined

PLEASE RETURN THE APPLICATION FORM VIA EMAIL:

bursaryapplications2017@wrseta.org.za
OR
DELIVER AT YOUR NEAREST W&RSETA OFFICES

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