BURSARY APPLICATION

IMPORTANT INFORMATION
  • The bursary is STRICTLY available to the previously disadvantaged individuals, with preference given to women and people living with disability.
  • The prospective applicant should be in need of financial aid, and should be able to prove the need.
  • The prospective applicant or parent/guardian must produce proof of income and expenditure to assist PSETA to further assist the need.
  • A minor who does not have parents must submit an affidavit to that effect.

1.LEARNER DETAILS
2.1Surname of learner: ______
Full names: ______
2.2 Identity number:
2.3 Date of birth: ______
2.4Gender: ______
2.5 Race: ______
  1. 2.6 Do you have a disability, as contemplated by the Employment Equity Act 55 of 1998?
  2. (The Employment Equity Act defines a disability as a long-term or recurring physical or mental impairment which substantially limits prospects of entry into, or advancement in, employment.). ______Yes/No
if yes, please describeyour disability: ______
2.7 Home address: ______
  1. 2.8 Postal address: (if different from above): ______
  2. Province of origin: ______
  3. 2.9 E-Mail address: ______Telephone No: ______
2.10 What language/s do you speak at home?______
2.11 Are you a South African citizen? Yes/No
If no, specify and attach documents indicating your status, for example: permanent residence, refugee, etc.
______
2.12 Highest level education: ______
(for example: Grade 12, ABET Level 3)
2.13 Are you currently receiving any financial aid?
If YES give details:
______
2.13 Have you previously received any financial aid?
IF YES give reasons for its termination: ______
2.14 Name and address of institution you intend enrolling or are currently enrolled with:
______
Please attach proof.
2.15 Course and year of study you intend enrolling for: ______
2.16 Are you employed/unemployed? ______
If employed, what is your occupation? ______
Full name and address of your employer: ______
(please note that employees whose employersPSETA constituent members will be given priority)
2.15 Do you intend studying full time or part time? ______
2.17 If you are employed, when did you start work with your employer? ______
3. PARENT OR GUARDIAN DETAILS
(To be completed if learner is a minor – i.e. unmarried person under 21 years)
3.1 Surname of parent/guardian: ______
Full names: ______
3.2 Identity number: ______
3.3 Home address: ______
3.4 Postal address (if different from above): ______
3.5 Telephone number: Home: Work:
3.6 E-mail address:

4. Declaration by applicant or parent/legal guardian

I ______, parent/guardian of ______do hereby confirm that the information given above by my child/ward is to the best of my knowledge true and correct.

OR

I ______do hereby confirm that I am the applicant and that the information I have given above is to the best of my knowledge true and correct.

5. Signatures

Learner’s signature: Parent or guardian’s signature:

(Only if the learner is a minor)

______

Date: ______Date: ______

Witness: Witness:

______

Date: ______Date: ______

pg. 1 PSETA Bursary Application Form