The Pybus Postgraduate Scholarship Application Form, Academic year 2017-18

Your application will only be considered if you answer all relevant sections fully and attach the relevant supporting documentation (see final page of this application form for guidance).

Degree Programme:
Month and year of the start of your Degree:
M / M / Y / Y
/ M / M / Y / Y
Expected month and year of completion:
Confirm that you are a registered student or Yes □ No □
have accepted a place at Newcastle University


Income (you/you and your partner) / Expenditure (you/you and your partner)
Money from parents/family
Including money for tuition fees & living costs / £ / Food / £
Postgraduate Loan / £ / Household consumables
(e.g. toiletries, laundry) / £
Professional Career Development Loan / £ / Clothes & Personal(e.g. haircuts) / £
University Scholarship / £ / Gas/Electricity/Water (utilities)(your share) / £
External Scholarship/Grant/Trust/Charity
(specify below) / £ / TV Licence(your share) / £
Paid work (after tax, NI etc.) / £ / Internet/Broadband(your share) / £
Contents insurance / £
Savings at the start of the academic year
(Do not enter negative amounts i.e. overdrafts) / £ / Socialising/Sport/Entertainment / £
Benefits & Tax Credits
(specify below) / £ / Mobile ‘Phone / £
Tuition Fees / £
Child Maintenance (from former partner) / £ / Accommodation
Rent Mortgage Hall fees / £
Partner’s Earnings (net)(if co-habit/married) / £ / Medical/Dental/Optical(please specify) / £
Partner's Income(other than earnings) / £ / Insurance
Please specify type of insurance below: / £
16/17 returned accommodation deposit / £
Disabled Students’ Allowances / £ / Transport - Local / £
Other(please specify below) / £ / Transport – Travel home / £
Car Costs(road tax, fuel, insurance, MOT etc.) / £
Course Costs (e.g. books, photocopying, equipment, travel to graduate job interviews) / £
Compulsory course related field trips / £
Council Tax / £
Disability costs not covered by DSA ( / £
Essential minimum debt(only enter minimum repayments over academic year) / £
Registered Childcare Costs / £
Other (please specify below) / £
TOTAL INCOME / £ / TOTAL EXPENDITURE / £

Data Protection:

In order to conduct certain parts of its business, for example communicating with you as an applicant, monitoring recruitment campaigns, the University will need to retain personal data that you have supplied in this form. The retention of any data will be conducted in accordance with the Data Protection Act (1998) and will not normally be retained for more than two years. Please feel free to contact us if you wish to view the data that has been retained, or if you do not wish for any data to be retained.

Terms and Conditions:

Please note that you have an obligation to inform the University immediately of any change in your circumstances that have significance to your application.

Please disclose any other scholarships or bursaries that you have applied for or have been awarded:

Please return the completed form and supporting documentation to

STOP …. STOP …. STOP ….. STOP…. STOP …. STOP …. STOP ….

Supporting Document Checklist(please provide copies only – originals will not be returned)

The following documents (that are applicable to you) MUST be supplied with your application – without them your application will NOT be assessed.

Last 3 month’s continuous bank statements from all accounts with a brief explanation next to all large or frequent transactions - either deposits or withdrawals - amounting to £100 plus. If print-outs are provided they must contain your name and account number.

Where applicable, please ensure that you have also included your partner’s bank statements.

Last 3 month’s continuous statements for all credit or store cards with a brief explanation next to all large or frequent transactions amounting to £100 plus. If print-outs are provided they must contain your name and account number.

 Evidence of Postgraduate Master’s Loan, Professional Career Development Loan / Research Council or other sponsor documentation relating to funding for your course.

Evidence of loans, earnings, tax credits or other benefits.

Where applicable, please ensure income and / or earnings and provided evidence of income.

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