/ Also administering EGHAM UNITED CHARITY (Registered Charity No. 205885) and STEWART’S AND BUDGEN’S ALMSHOUSES (Registered Charity No. 205886)
Registered Charity No. 311941

Grants for full or part-time Further Education and vocational students who still rely on parental financial support (including Foundation Year University students)

This form is specific to applicants aged 16 – 25.

PART 1: Personal details
Name: / Mr Mrs Ms Miss
Age:
Home address
Address:
Phone (home):
Phone (mobile):
Email:
No. of years' residence in area of benefit (Egham, Englefield Green, Hythe or Virginia Water):
Contact details during term time (if different from above)
Address (term time):
Phone (term time):
Course details
Presently studying at:
Course:
Course start date:
Course end date:
Academic history since age 16 (give dates/qualifications):
PART 2: Sponsor / Referral Agency (if applicable)
Name: / Mr Mrs Ms Miss
Agency:
Address:
Phone (office):
Phone (mobile):
Email:
PART 3: Details of your budget plan
A) Details of the expenses you expect to incur on the course. How much in total do you have to raise?
B) How do you plan to raise the remainder, over and above any grant from the Trust?
PART 4: Personal and family finances
The parent/guardian should complete this PART to satisfy the Trustees that the student is in genuine need.
COMBINED PARENTAL INCOME AND CAPITAL:
INCOME (monthly) / (if none, write ‘none’) / OUTGOINGS (monthly) / (if none, write ‘none’)
Salary / £ / Rent/Mortgage (net after Housing Benefit, if any) / £
Pension / £ / Council Tax (net after Council Tax benefits, if any) / £
Income from Savings / £ / Heat and Light / £
Benefits or Allowances / £ / HP/Clubs etc. / £
Contributions from other members of the household / £ / Debt repayments / £
Maintenance from former partner / £ / Other main costs (please give details) / £
CAPITAL / DEBTS
Do you own your own house? / YES NO / Do you have a mortgage? / YES NO
Building Society deposits / Savings / £ / Other debts (please give details) / £
STUDENT’S INCOME AND OUTGOINGS:
INCOME (monthly) / (if none, write ‘none’) / OUTGOINGS (monthly) / (if none, write ‘none’)
Grants/Bursaries/Sponsorship / £ / Rent/Mortgage / £
From Parent/Guardian / £ / Council Tax / £
From Holiday Work / £ / Heat and Light / £
Any other source / £ / Course Fees / £
Other main costs (please give details) / £
Any other factors the Trustees should take into account? Please attach a note explaining any other factors not already covered by this form.
Total grant request from Egham Education Trust : / £
If the Trustees award a grant, please make the cheque payable to:
(signed) Applicant: / Parent / Guardian:
Date:

Please send the completed application to: The Secretary, Egham Education Trust, 33 Runnemede Road, Egham, Surrey TW20 9BE or email to .

The information given in this Form is protected under the terms of Chapter 29 of the Data Protection Act 1988 [as Amended 2001] and will not be divulged to any person[s] other than the Trustees and Administrators of the Charity without the express permission of the Applicant.

EM_FE 10-2016