Payment Details
Please confirm your bank details to enable payment directly into your bank account.
Bank Name:Sort Code:
Account Number
Account Name:
Reference number – for Building Society Accounts:
There is an expectation that students will have opened a student bank account with overdraft facility before making an application to the Financial Assistance Fund.
If you do not have a student bank account, please provide an explanation.
I declare that the information I have given on this form is correct and complete to the best of my knowledge.
I understand that failing to disclose all relevant information and/or giving false information will automatically disqualify my application and may also lead to disciplinary procedures resulting in possible expulsion from the University.
I further undertake to repay any loans / grants obtained by me as a result.
Your Signature / DatePlease return your form to:
Students at Kingsway, Parkgate Road, Queens Park, Riverside and Thornton campusesandUniversity Centre Shrewsbury: / Students at Warrington campus,ClatterbridgeLeighton:Student Support Funds Officer
Student Support & Guidance
Binks 1.13
University of Chester
Parkgate Road
Chester
Cheshire
CH1 4BJ / Student Support Funds Officer
Student Support & Guidance
Martin 0.12
University of Chester
Crab Lane
Warrington
Cheshire
WA2 0DB
Tel: / 01244 511550 / Tel: / 01925 534282
e-mail: / / e-mail: /
Parent/Partner Pro Forma
You should have applied for a means-tested assessment by Student Finance or NHS Bursaries(for Health & Social Care programmes). If this assessment confirms that you do not qualify for the maximum grant of £3,387 (for household incomes less than £25,000 this academic year), or for the maximum NHS Bursary, then it is expected that your parents/ guardian/partner will make up the shortfall in your funding.
This amount should be entered as parental/partner contribution on your Financial Assistance Fund form. However, if your parents/partneris unable to provide this expected contribution, or you did not apply for a means-tested assessment, please ask them to complete the details below and submit this form with your application.
Did your son/daughter/partner request a means-tested assessment by Student Finance or NHS Bursaries?Assessed household incomes up to £50,000 may qualify for the higher rate of Maintenance Loan from Student Finance. Students should, therefore, apply for a means-tested assessment, even if they are above the qualifying threshold for the Maintenance Grant. / Delete as appropriate
Yes / No
If no,please explain below.
Parent/partner’s expected contribution, following means-tested assessment?
How much are youactually able to contribute to your son/daughter/partner’s funding this academic year?
Please provide a clear account of your situation, including the main reasons why you are unable to provide the expected contribution to make up your son/ daughter /partner’s means-tested funding. If your son/daughter/partner did not apply for a means-tested assessment, please provide an explanation here. If you have any evidence to support your statement, please provide this.
continue overleaf if necessary
Student’s Name
Parent/partner’s Name
Parent/partner’s Signature / Date:
Completed Pro Forma should be submitted with the Financial Assistance Fund Application where necessary.