/ Tel: (012) 664-8459
Fax: (012) 644-2731

APPLICATION FORSAMHS FUND UNDER-GRADUATE STUDY GRANT

CLOSING DATE: 27 FEBRUARY 2016

Criteria for the allocation of study grants.

SAMHS Fund study grants are awarded on merit to SAMHS Fund contributors.
Grants are available to the principal contributoror one dependent per household.
The grants are only for second or subsequent years of under-graduate study.
Qualifying institutions: Universities, Universities of Technology and Technical Colleges
Applications from students studying on state expense will not be considered.
Students who already receive study bursaries will be excluded.

N.B. Fraudulent claims will be managed under the appropriate regulations.

Documentation to please be submitted with the application form:

  1. Certified copy of applicant’s Identity Document;
  2. Certified copy of Examination results of 2015;
  3. Certifies copy of proof of Registration for 2016; and
  4. Recommendation by GOC / OC/ Dir (Par 8).
  5. Copies may be faxed / e-mailed. However the original documents must still reach this office for processing.

1.DETAILS OF SAMHS FUND CONTRIBUTOR

ID No: / Force No:

Surname:______

Full Names:______

Postal Address:______Code: ______

Physical Address: ______

______Code: ______

Unit: ______

Cell no: ______Tel Work: ______

2.APPLICATION IS MADE FOR A STUDY GRANT FOR:

Relationship to contributors (i.e. Self/Spouse/Daughter/Son): ______

ID No:

Surname:______

Full Names: ______

3.DETAIL OF STUDY YEAR: 2016

a.Name of Institution/University: / ______
b.Study Course: / ______
c.Year of Study : / 2ND / 3RD / 4TH / 5TH / 6TH

4.I UNDERSTAND THAT THIS GRANT WILL BECOME IMMEDIATELY REPAYABLE IF:

The dependant ceases studies during the year.

5.I HEREBY CERTIFY THAT:

a.Above-mentioned candidate is a bona-fide dependant of mine as defined in Chapter V of the General Regulations of the South African National Defence Force and the Reserve.

  1. All information given above is true and correct.

6.BANKING DETAILS FOR ELECTRONIC TRANSFER OF FUNDS FROM SAMHS FUND

Bank: ______Branch Name: ______

Branch Code / Acc Nr
Cheque / Transmission / Savings

7.Cell phone number for Bank notification of transfer: ______

SIGNATURE MEMBER: ______DATE: ______

8. CONFIRMATION or RECOMMENDATION BY GOC or OC or DIRECTOR

______

SIGNATURE: GOC /OC/DIR DATE