UNIVERSITY OFSTELLENBOSCH

MATIES SPORT

Private Bag X1

Tel:(021) 808-4642Matieland

Fax:(021) 808-48977602

APPLICATION

FOR A SPECIAL BURSARY FOR SPORT

ABURSARY CONDITIONS

1.No application for a bursary will be considered unless the form has been completed in full.

2.Special bursaries forsport are only awarded to prospective or current students which have been academically accepted by the university.

3.Even though special bursaries for sport are achievement-based and are linked directly to sport achievements, the university reserves the right to cancel or decrease any bursary allocations if the bursary holder underachieves on academic and sport levels.

4.Special bursaries for sport are awarded yearly, based on sport achievements in the previous year. A bursary allocation for a specific year does not mean that the bursary holder will automatically receive a bursary the following year. Applications must be submitted yearly for consideration.

5.The form must be completed in clear, readable block letters and be handed in yearly at the Sport Bureau before the end of February.

BPERSONAL PARTICULARS

1.Surname: ______

2.Name (in full): ______

3.Studentnr: ______4. Date of Birth ______

5.Addressin Stellenbosch: ______

______

6.Initials and surname of parent or guardian: ______

7.Postal address (parent/guardian): ______

______

8.Telephone (parent/guardian): ______

9.Occupation (parent/guardian): ______

2 / ......

- 2 -

CACADEMIC PARTICULARS

1.Course: ______

2.AcademicYear: ______

DSPORT ACHIEVEMENTS

1.Type of Sport: ______

2.Highest achievement attained:

(Give particulars of team or event it took place)

2.1International: ______Year: ______

2.2National: ______Year: ______

2.3Provincial: ______Year: ______

3.If a team sport, indicate position played: ______

4.If individual sport, indicate item and best achievement:

4.1Item: ______Achievement: ______

4.2Item: ______Achievement: ______

4.3Item: ______Achievement: ______

5.Particulars of Coach:

5.1Initial surname: ______

5.2Telephone: ______Code: ______

I declare the abovementioned information as being correct.

SIGNATURE / DATE

If the applicant is a prospective student, this form must be signed by the parent or guardian.

SIGNATURE / CAPACITY
(Parent/Guardian) / DATE