WINCHMORE SCHOOL

16-19 Bursary Fund Application

2016-2017

Winchmore School - Application for 16 to 19 Bursary Fund 2016 – 2017

1. Overview

You could get a bursary to help with education-related costs if you’re aged 16 to 19 and:

  • studying at school or college (not university) in England
  • on a training course, including unpaid work experience

What a bursary is for

A bursary is money that you, or the School, can use to pay for things like:

  • clothing, books and other equipment for your course
  • transport and lunch on days you study or train

2. What you'll get

There are 2 types of 16 to 19 bursary.

Vulnerable student bursary (Tier 1)

You could get a bursary worth up to £1,200, depending on your circumstances and benefits.

Discretionary bursary (Tier 2)

You could get a discretionary bursary if you need financial help but don’t qualify for a vulnerable student bursary. The School decides how much you get and what it’s used for. It is currently £20 per week for 100% attendance and excellent behaviour.

How your bursary is paid

You will be paid by cheque in instalments as per the schedule below:

Cut-off date / Actual Payment
Payment 1 / 14 October 2016 / 21 October 2016
Payment 2 / 2 December 2016 / 9 December 2016
Payment 3 / 13 January 2017 / 20 January 2017
Payment 4 / 10 February 2017 / 24 February 2017
Payment 5 / 17 March 2017 / 24 March 2017
Payment 6 / 28 April 2017 / 5 May 2017
Payment 7 / 26 May 2017 / 9 June 2017
Payment 8 / 30 June 2017 / 7 July 2017
Payment 9 / 21 July 2017 / 21 July 2017

The School may offer one-off payments to cover study trips or travel for university interviews.

The School could stop payments if you break our Learner Agreement, eg about attendance or how your bursary is used.

3. Eligibility

Who can get a bursary

Vulnerable student bursary (Tier 1)

You may be entitled up to £1,200 if at least one of the following applies:

  • you’re in or recently left local authority care
  • you get Income Support (or Universal Credit in place of Income Support) in your name
  • you’re disabled and get both Employment and Support Allowance (ESA) (or Universal Credit in place of ESA), and either Disability Living Allowance (DLA) or Personal Independence Payment (PIP) in your name

You may get the full amount if you have expenses and study full-time on a course of at least 30 weeks. You’ll usually get less, or no bursary, if your course is shorter, you study part time or have few expenses.

You’ll be told what evidence you need, eg benefit letters.

Discretionary bursary (Tier2)

You must be in receipt of Free School Meal allowance. For guidance please visit:

4. How to claim

Complete attached application form and pass to Ms Plaza in the 6th Form Office

Application for Support from the Winchmore School Bursary Fund 2016 –17

Section 1
1.1. Your Name:
Surname/Family Name: / First Name(s)
1.2. Your Address:
Postcode:
1.3. Date of Birth:
1.4. Your Contact Details:
Mobile Number: / Home Number:
Email:
1.5. Are you an Asylum Seeker? YES  NO 
1.6. Are you enrolled at Winchmore School as a full time student with 12 or more teaching or tutor hours on your timetable each week? (This includes any lessons attended offsite under the collegiate arrangement)
YES  NO 
Section 2
2.1.Do you live with adults who are mainly responsible for you? (If you live with Foster Parents answer No to this question)
YES  NO 
2.2.Are you in Local Authority care, a care leaver or living with foster parents?
YES  NO 
2.3.Do you currently receive Income Support or Universal Credit? (NB not your parent/guardian)
YES  NO 
2.4.Are you disabled and in receipt of both Employment Support Allowance (or Universal Credit) and Disability Living Allowance (or Personal Independence Payments)?
YES  NO 
If you have answered ‘YES’ to questions 2.2, 2.3, &/or 2.4, please provide supporting information including the following:
  • Details of Local Authority involvement, including written confirmation of your current or previous looked after status from the local authority which looks after you or provides your leaving care services, including the name & contact details of the Social Worker /responsible adult.
  • Copies of most recent statement of benefit entitlement.

If you answered ‘NO’ to 2.1 &/or ‘YES’ to 2.2, 2.3, &/or 2.4, you may be entitled to Tier 1 Support from the Winchmore School Bursary Fund, provided you can provide the evidence detailed above.
You must complete the Sections 3 & 5, but the only evidence you must provide is that detailed above.
Only complete Section 4 if you wish to apply for support in addition to Tier 1 support.
Section3
3.1. Are you currently in receipt of or entitled to Free School Meals?
YES  NO 
3.2 Do you have a Zip Oyster card?
YES  NO 
3.3 Do you qualify for Free Travel using your Oyster Card?
YES  NO 
If you have answered ‘YES’ to question 3.1, your claim will be validated from the Local Authority advices to the school. If you are included on the list from the Local Authority, you may be entitled to Tier 2 Support from the Winchmore School Bursary Fund.
  • You must complete Section5, but you do not need to provide any further evidence of Parent or Guardian Income.
  • Only complete Section 4 if you wish to apply for support in addition to Tier 2 support.

Section 4 ONLY FOR HARDSHIP APPLICATIONS
4.1Do you wish to apply for support from the Winchmore School Bursary Fund on the basis of Hardship?
YES  NO 
4.2 Do you CURRENTLY receive Bursary Fund Payments from us or elsewhere?
YES  NO 
If you wish to apply on the basis of hardship, you will need to establish your needs and substantiate your entitlement based upon the financial circumstances of your parent &/or carers (or yourself if Tier 1 support is applicable).
Claims based upon hardship may be for individual, one off items – such as help with field trips or one off necessary purchases, or to assist with ongoing necessary expenses.
All must be explained and evidenced, including parent or carer circumstances.
A Parent or Carer Declaration must be completed ONLY FOR CLAIMS BASED UPON HARDSHIP.
Needs: Please provide full details and costings; this may includeTransport, Meals whilst studying, Books & Equipment, and anything else relevant to your education such as Trips or Visits.
*This must include full details and costing; please use a supplementary sheet if required.
Reasons for HARDSHIP request for support from the Bursary Fund:
Please explain briefly why you need assistance from the Bursary Fund – for example Household Income falling under £20, 817 in the tax year 2015 to 2016.(THIS IS NOT REQUIRED FOR TIER 1 or TIER 2 APPLICATIONS)
Section 5 - FOR ALL APPLICANTS
Data Protection Statement
The information you provide on this form will be stored by Winchmore School and used to assess and administer support from the school Bursary Fund. It may be shared with other interested parties such as the Department for Education, EFA and the YPLA. It will not be used for marketing or sales purposes. The school is registered under the Data Protection Act 1998.
Declaration:
If you give false or incomplete information, we may refer to the DfE or police, and you may be prosecuted. If you fail to provide evidence when requested or the evidence provided results in a lower award or failure to meet the eligibility criteria, future payments may be stopped and we may seek repayment of anything paid.
I have read and understood the Data Protection Statement and declare that the information given on this form is correct and complete to the best of my knowledge and belief.
I understand that:
  • If I do not keep to my Bursary Fund Student Agreement, or if I leave my learning programme, I will not be eligible to receive any further payments; and any Bursary Fund overpayment may need to be repaid by me to the school.
  • I am not allowed to receive Bursary Fund payments at the same time as any other government training or learning allowanceand any other payments must be declared.
  • The information I have given may be shared with other agencies or organisations, as allowed by law, for the purposes of checking my application and/or the prevention of fraud.
Signed: ……………………………………………………………… Date: ………………………
If you are applying on the basis of hardship for Tier 3 Support and you are not a young person living independently on Income Support, please ask your parents or carers to complete the next section and declaration.
Parent or Carer Declaration – Hardship Applications ONLY
I am/We are the adults mainly responsible for the young person named on this form and applying for support from the Winchmore School Bursary Fund on the basis of hardship.
PLEASE NOTE - YOU NEED NOT COMPLETE THIS SECTION IF YOU ARE APPLYING FOR SUPPORT UNDER TIER 1 OR TIER 2
Adult 1 / Adult 2
Surname/Family Name / Surname/Family Name
First Name / First Name
Relationship to Young Person:
 Mother
 Father
 Aunt
 Uncle
 Grandfather
 Step-parent
 Partner of parent
Other (Please state) ………………………………………………
National Insurance Number: ______ /  Mother
 Father
 Aunt
 Uncle
 Grandfather
 Step-parent
 Partner of parent
Other (Please state) ………………………………………………
National Insurance Number: ______
Does the young person live with you at the given address? YES  NO 
Income From Employment:
Write in the total taxable pay as an employee from all jobs before taking off tax and National Insurance contributions as shown on your P60 or P60U forms for 2015 to 16. You will need to provide a copy of this document.
Adult 1 £ / Adult 2 £
Write in the total taxable income from self employment. You will need to provide a copy of your Self Assessment Tax Calculation form (SA302) for 2015 to 16.
Adult 1 £ / Adult 2 £
Other Income – this is to include pensions, income from savings, income from property, trusts, settlements and estates as well as any foreign income converted to a sterling equivalent:
Adult 1 £ / Adult 2 £
Data Protection Statement
The information you provide on this form will be stored by Winchmore School and used to assess and administer support from the school Bursary Fund. It may be shared with other interested parties such as the Department for Children Schools and Families and the EFA. It will not be used for marketing or sales purposes. The school is registered under the Data Protection Act 1998.
Declaration:
If you give false or incomplete information, or if you do not tell us about any part of your income that is relevant, you may be prosecuted. If you fail to provide evidence when requested or the evidence provided results in a lower award or failure to meet the eligibility criteria, future payments may be stopped and we may seek repayment of anything paid.
I/We have read and understood the Data Protection Statement and declare that the information given on this form is correct and complete to the best of my/our knowledge and belief.
I/We understand that:
  • I/We share responsibility for the information given with any partner named on this form
  • If the young person named on this form does not keep to their Bursary Fund Agreement, or if they leave their learning programme, they will not be eligible to receive any further payments; and any Bursary Fund overpayment may need to be repaid to the school
  • The information I/we have given may be shared with other agencies or organisations, as allowed by law, for the purposes of checking and assessing an application for support from the Bursary Fund and/or the prevention of fraud

Adult 1
Signed: ………………………………………………………………………… / Adult 2
Signed: …………………………………………………………………………
Date: ………………………… / Date: …………………………

BURSARY FUND APPLICTION CHECKLIST

FOR SCHOOL STAFF USE ONLY – STUDENTS DO NOT COMPLETE THIS SECTION

Name: / UPN:
Sims – enrolled - Yes No  / Tier 1 - Yes No 
Sims – FSM - Yes No  / Tier 2 - Yes No 
Hardship:
Meeting Date: / Present: LHU /CSI
Decision:
Comments:
Signed: / Signed:
Lisa Hughes / Amelia Plaza
Administration
App Form Complete / School Agreement Signed / Agreed/Declined / Add to Spreadsheet / Letter to Student