APPLICATION FOR: Aberystwyth Alumni Student Summer Hardship Fund 2016 - 2017

APPLICATION FOR: Aberystwyth Alumni Student Summer Hardship Fund 2016 - 2017

Supporting evidence checklist / Yes / No
1 / Completed form (Including budget and all other sections)
2 / Confirmation of funding (Letter from Student Finance or equivalent)
3 / 3 months bank statements (all bank accounts, please describe all transactions over £100 that appear on the statements)
4 / Cashpoint mini slip showing available balance
5 / Tenancy agreement (Not required for University accommodation)
6 / Personal statement
7 / Parental form – this is only needed if your student maintenance loan / grant is less then £6000 in total

DEADLINE: Friday July 14th 2017

Part 1.  Personal Details

1.  FULL NAME: ______

2.  HOME ADDRESS: ______

______

3.  ABERYSTWYTH ADDRESS: ______

______

4.  YEAR IN UNIVERSITY (1st, 2nd, 3rd): ______

5.  YEAR OF STUDY (1st, 2nd, 3rd): ______

6.  DEGREE SCHEME (e.g. BA History): ______

Part 2.  Complete your annual budget plan over the 52 weeks 2016-17

(Note the Basic living expenses figure we put in is based on the government figure of £80 per week, and is the standard figure we use in calculating hardship. You will get a chance to enter your detailed budget on the next page)

Income / Annual £ / Outgoings / Annual £
Maintenance Loan: / Term Time Rent:
Maintenance Grant: / Summer Rent:
Aber Bursary: / Basic Living Expenses: / 4160
Parents: / Exceptional costs (Travel):
Work: / (Course):
Other Income: / (Health):
TOTAL : / TOTAL:

Part 3.  Debts – please provide evidence

Creditor – person / company / bank owed / AMOUNT £ / Nature of debt e.g. overdraft, rent, credit / store cards

Part 5.  PERSONAL BUDGET : This Section must be completed in full

All amounts should be averaged out to a weekly amount (over 52 weeks).

EXPENDITURE / AMOUNT £
Accommodation
Food / Toiletries / Laundry
Utility Bills: Electricity, Gas, Water
Clothes and Shoes
Telephone
Leisure (clubs / societies)
Insurance (property, life, car)
Daily Travel
Travel home
Other expenditure Internet
Car costs
Health costs (eye care, dental care diagnostic tests)
Other Course costs (Books / Equipment/Trips)
Childcare
Other
Total Expenditure per week
Weekly Income (from Part 2)

Part 6.  Supporting Statement

Please explain why you are in financial difficulty and require additional support. Continue on a separate sheet if necessary.

Please explain what steps you have taken to address your financial difficulties, e.g. review your overdraft, work

Part 7.  Parental Statement in support of student hardship application

All eligible students are entitled to a basic amount of financial help from student finance. The Student Finance award is intended to cover 12 months and is based upon household income. It is therefore assumed that parents, spouse or partners’ will contribute towards supporting their student.

Parents’ name:-

Students name and ID:-

Are you financially supporting your child?:-

If yes how much financial assistance do you provide - …n/a…….weekly/monthly/annually

Unfortunately, the Student Hardship Fund is unable to provide long term financial support in lieu of an assessed parental contribution.

Please detail below the reasons as to why you are currently unable to support your student over the summer vacation.

Are there any special or unforeseen circumstances which have resulted in withdrawing financial support’ if so please provide details below.

Declaration

I certify that the information detailed above is correct and I understand giving false information may constitute as fraud which the University takes very seriously and may pursue through criminal matters.

Parents signature: …………………………………………………………..
Date:………… …………………………………..

Part 8.  Bank / Building Society Details

Any award will be paid into the first account shown below

Account / 1 / 2 / 3 / 4
Bank / BS name
Sort Code
Account Name
Account No
Roll no (Building society only)
Overdraft limit
Current balance

SIGNATURE ………………………………………………… DATE ………………………

Completed forms should be returned to:

Student Support Services,

Reception, Ground Floor, Student Welcome Centre,

Penglais Campus, Aberystwyth,

SY23 3FB.

Monday to Friday, 10am – 3pm

Email:

Telephone: 01970 621 761

Deadline: Friday July 14th 2017

2 | Page