Apply for a Bursary

Child's Details

Name(Required)

First Last

Date of Birth(Required)

Year of Entry(Required)

Applying for(Required)

Year 7

Year 12

Daughter's ethnicity?(Required)

This Information is requested to ensure that we comply with our Equal opportunities policy.

Please refer to the guidance notes when completing this part of the application.

Parent/Guardian Details

Are you a single parent/guardian?(Required)

Yes

No

First Signatory

Name(Required)

Title First Last

Contact Tel No.(Required)

Relationship to Child(Required)

Email Address(Required)

Postal Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Employment Status(Required)

Employment Details

Occupation(Required)

Work telephone No.(Required)

Name & address of employer or business address including postcode(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Second Signatory

Name(Required)

Title First Last

Contact Tel No.(Required)

Relationship to Child(Required)

Email Address(Required)

Postal Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Employment Status(Required)

Employment Details

Occupation(Required)

Work telephone No.(Required)

Name & address of employer or business address including postcode(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Hidden

Signatory Details

Name(Required)

Title First Last

Contact Tel No.(Required)

Relationship to Child(Required)

Email Address(Required)

Postal Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Employment Status(Required)

Employment Details

Occupation(Required)

Work telephone No.(Required)

Name & address of employer or business address including postcode(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Parental Responsibilities

Please indicate the reason this application is being completed by one parent only(Required)

Please provide any relevant details(Required)

Does the other parent/guardian have parental responsibility for this child?(Required)

Yes

No

Please provide any relevant details(Required)

Please refer to the guidance notes when completing this part of the application.

Income (Per Annum)

Please complete the fields below showing income from ALL SOURCES, before deduction of any tax. If not applicable enter 0.

First Signatory

Gross Salary

2022/23 Actual £ Per annum

2023/24 Estimate £ Per annum

Payslip, P60, P11D

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Business profits/Self Employed earnings

2022/23 Actual £ Per annum

2023/24 Estimate £ Per annum

Business Accounts, Tax Return

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Gross pensions received

2022/23 Actual £ Per annum

2023/24 Estimate £ Per annum

Supporting documentation

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Second Signatory

Gross Salary

2022/23 Actual £ Per annum

2023/24 Estimate £ Per annum

Payslip, P60, P11D

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Business profits/Self Employed earnings

2022/23 Actual £ Per annum

2023/24 Estimate £ Per annum

Business Accounts, Tax Return

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Gross pensions received

2022/23 Actual £ Per annum

2023/24 Estimate £ Per annum

Supporting documentation

Drop files here or

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Hidden

Signatory Details

Gross Salary

2022/23 Actual £ Per annum

2023/24 Estimate £ Per annum

Payslip, P60, P11D

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Business profits/Self Employed earnings

2022/23 Actual £ Per annum

2023/24 Estimate £ Per annum

Business Accounts, Tax Return

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Gross pensions received

2022/23 Actual £ Per annum

2023/24 Estimate £ Per annum

Supporting documentation

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Please read item number 5 in the guidance notes before completing this section.

Assets

Bank/Building Society

How many bank/building society accounts do you have?(Required)

Account 1

Bank/Building Society Name(Required)

Balance £(Required)

Statement (last 3 months)(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Account 2

Bank/Building Society Name(Required)

Balance £(Required)

Statement (last 3 months)(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Account 3

Bank/Building Society Name(Required)

Balance £(Required)

Statement (last 3 months)(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Account 4

Bank/Building Society Name(Required)

Balance £(Required)

Statement (last 3 months)(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Other Investments (eg ISA, Bonds, Stocks & Shares)

How many other investments would you like to add?(Required)

Investment 1

Type of Investment(Required)

Balance £(Required)

Statement(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Investment 2

Type of Investment(Required)

Balance £(Required)

Statement(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Investment 3

Type of Investment(Required)

Balance £(Required)

Statement(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Investment 4

Type of Investment(Required)

Balance £(Required)

Statement(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Properties

How many properties do you own?(Required)

List all properties you own including where you live (if you own that property)

Property 1

Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Mortgage outstanding on property(Required)

Estimated value of property(Required)

Property 2

Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Mortgage outstanding on property(Required)

Estimated value of property(Required)

Property 3

Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Mortgage outstanding on property(Required)

Estimated value of property(Required)

Property 4

Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Mortgage outstanding on property(Required)

Estimated value of property(Required)

Please refer to the guidance notes when completing this part of the application.

Outgoings

I/we have the following monthly outgoings

Mortgage payments

Rental payments

Pension contributions

Loan and Credit card payments

Other large outgoings

Mortgage payments

Amount - monthly(Required)

Mortgage statement for each property(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Rental payments

Amount - monthly(Required)

Rent agreement/contract/letter(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Pension contributions

Amount - monthly(Required)

Pension letter(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Loan and Credit card payments

Amount - monthly(Required)

Loan/credit card statements(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Other large outgoings

Amount - monthly(Required)

Letters/statements(Required)

Accepted file types: doc, docx, pdf, jpg, jpeg, gif, png, Max. file size: 10 MB.

Please refer to the guidance notes when completing this part of the application.

Dependent Children

Please give details of ALL dependents, including the child for whom this application is made. If applicable, add details of any current bursary award you are in receipt of from another school(s).

How many dependent children would you like to add?(Required)

Dependent 1

Name of dependent(Required)

Date of birth(Required)

Relation to dependent/Reason dependency(Required)

Amount of any allowance received (£ Annually)(Required)

Dependent 2

Name of dependent(Required)

Date of birth(Required)

Relation to dependent/Reason dependency(Required)

Amount of any allowance received (£ Annually)(Required)

Dependent 3

Name of dependent(Required)

Date of birth(Required)

Relation to dependent/Reason dependency(Required)

Amount of any allowance received (£ Annually)(Required)

Dependent 4

Name of dependent(Required)

Date of birth(Required)

Relation to dependent/Reason dependency(Required)

Amount of any allowance received (£ Annually)(Required)

Please refer to the guidance notes when completing this part of the application.

Other Dependents

If you qualify for a Carer’s Allowance, or have an aged grandparent or relative living with you or dependent upon you, please provide details including age, address, condition, etc.

How many other dependents do you have?(Required)

Dependent 1

Name of dependent(Required)

Date of birth(Required)

Relation to dependent/Reason dependency(Required)

Amount of any allowance received (£ Annually)(Required)

Dependent 2

Name of dependent(Required)

Date of birth(Required)

Relation to dependent/Reason dependency(Required)

Amount of any allowance received (£ Annually)(Required)

Dependent 3

Name of dependent(Required)

Date of birth(Required)

Relation to dependent/Reason dependency(Required)

Amount of any allowance received (£ Annually)(Required)

Dependent 4

Name of dependent(Required)

Date of birth(Required)

Relation to dependent/Reason dependency(Required)

Amount of any allowance received (£ Annually)(Required)

Please refer to the guidance notes when completing this part of the application.

Any Other Relevant Information

Please use this space to add any other relevant information about your bursary application.

Declaration

Following completion of this form, the following declaration should be signed by both parents/guardians where possible and applicable.

I / We declare that to the best of my/our knowledge and belief, all particulars submitted are true and contain a full statement of my/our income from ALL sources during the period shown.

I /We understand that the provision of false information may lead to my; our child being disqualified from assistance under the scheme.

I /We undertake to report immediately any material change in the financial position declared on this form.

Submission copy email(Required)

First Signatory

Name(Required)

Title First Last

Date(Required)

Signature(Required)

Second Signatory

Name(Required)

Title First Last

Date(Required)

Signature(Required)

Hidden

Signatory

Name(Required)

Title First Last

Date(Required)

Signature(Required)

How We Use This Information

We will use the information included in this form to assess your family’s financial position and the level of bursary support you would need should we be able to offer your daughter a place at the school.

Bursary Application Forms, with supporting documents, are retained for the duration of time that a pupil is on the school role as a minimum. A new form is required to be completed on an annual basis.

If you are unsuccessful in obtaining financial assistance, we will retain your application for no longer than is necessary and not normally more than one year after receipt of your application.

Documents

Bursary Application

Child's Details

Parent/Guardian Details

First Signatory

Employment Details

Second Signatory

Employment Details

Signatory Details

Employment Details

Parental Responsibilities

Income (Per Annum)

First Signatory

Gross Salary

Business profits/Self Employed earnings

Gross pensions received

Second Signatory

Gross Salary

Business profits/Self Employed earnings

Gross pensions received

Signatory Details

Gross Salary

Business profits/Self Employed earnings

Gross pensions received

Other Income Details

Government Benefits

Child Benefit

Tax Credits

Income Support

Housing Benefit

Carer's Allowance

Other Benefits

Other Income

Income from properties

Income from investments

Maintenance payments/Allowances

Additional Income

Contributions

Assets

Bank/Building Society

Account 1

Account 2

Account 3

Account 4

Other Investments (eg ISA, Bonds, Stocks & Shares)

Investment 1

Investment 2

Investment 3

Investment 4

Properties

Property 1

Property 2

Property 3

Property 4

Outgoings

Mortgage payments

Rental payments

Pension contributions

Loan and Credit card payments

Other large outgoings

Dependent Children

Dependent 1

Dependent 2

Dependent 3

Dependent 4

Other Dependents

Dependent 1

Dependent 2

Dependent 3

Dependent 4

Any Other Relevant Information

Declaration

First Signatory

Second Signatory

Signatory

How We Use This Information