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Department of Correctional Services External Bursary Application Form 2022 Academic Year

This document is an application form for an external bursary from the Department of Correctional Services for the 2022 academic year. It requests personal details from applicants, including identity number, address, contact information, and disability status if applicable. It also asks for course details like the qualification sought, institution attended or to be attended, admission requirements, period of study, subjects, and any previous bursaries received. Applicants must attach documents like ID copies, academic records, course fees, and acceptance letters. The form concludes with references, a declaration of truth, and places for signatures and dates.

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Tandolwethu Mali
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183 views3 pages

Department of Correctional Services External Bursary Application Form 2022 Academic Year

This document is an application form for an external bursary from the Department of Correctional Services for the 2022 academic year. It requests personal details from applicants, including identity number, address, contact information, and disability status if applicable. It also asks for course details like the qualification sought, institution attended or to be attended, admission requirements, period of study, subjects, and any previous bursaries received. Applicants must attach documents like ID copies, academic records, course fees, and acceptance letters. The form concludes with references, a declaration of truth, and places for signatures and dates.

Uploaded by

Tandolwethu Mali
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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ANNEXURE G5

DEPARTMENT OF CORRECTIONAL SERVICES


EXTERNAL BURSARY APPLICATION FORM
2022 ACADEMIC YEAR

This form will be considered as incomplete and will be eliminated if the following documents are not attached
to this application:

 Certified copy of ID
 Certified copy of matric
 Course fee outline/quotation
 Acceptance Letter

A. PERSONAL DETAILS:

1. Identity number: …………………………………….. 2. Date of birth: ………………………….

3. Title: …………………………………………………     4. Gender: M F

5. Surname ……………………………………………. 6. Race: Black White Coloured Indian

7. Full names: ……………………………………………………………………………………………….

8. Disabled/Not disabled: If disabled, state the nature of disability…………………………………………

9. Physical Address:

……………………………………………………………………………………………………………

……………………………………………………………….. Postal Code ……………………………

10. Postal Address:

……………………………………………………………………………………………………………

……………………………………………………………….. Postal Code ……………….

11. Region/(Province) : …………………………………..

12. Telephone no: ……………………………..

Cell phone no: …………………………….. : E-mail address:…………………………………………

13. Next of kin:

Name: ………………………………………………………………………… Relation: …………………………..

Contact telephone numbers (H): ……………………………………………………………………………


(Cell) ………………………………………………………………………….

Residential Address…………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………

14. If employed, name and address of employer: …………………………………………………………

…………………………………………………………………………………………………………
B. COURSE DETAILS

1. Which qualification is this application for? ………………………………………………………………………………….

2. At which education institution are you enrolled /going to enroll? ………………………………………………..………..

2.1 Do you comply with the admission requirements: YES / NO


( If full-time studies please attach acceptance letter or proof of application for acceptance for both accommodation and
tuition)

3. Minimum period (if not commenced with studies yet) /remaining period of studies? ……………………………………….

4. In which academic year are you now? ………………………………………..


(attach results of previous years)

5. Type of tuition (Proof from the tertiary institution, confirming that the qualification/course is only offered on a full-time
basis, needs to be attached)

Part-time Full-time

6. Which subjects will be your major/s?

……………………………………………… …………………..……………………………………….

……………………………………………… …………………..……………………………………….

7. What is your highest qualification at present?........................................................................................................................

8. Are / were you a recipient of a bursary YES / NO


If yes, please complete:

a) Study field…………………………………………………………………………………………….
b) Bursary granted by: …………………………………………………………………………………..
c) Bursary period: ……………………………………………………………………………………….
d) Nature of obligations: …………………………………………………………………………………
e) Have you fulfilled the obligations: …………………………………………………………………….

9. Give your motivation why you want to do this course, what is the direct link of this
Qualification/course of study to your personal development plan?

……………………………………………………………………………………………………………………………..

…………………………………………………………………………………………………………………………….

2
C. DECLARATION BY APPLICANT

I ……………………………………………………………………ID NO:……………………………………..

HEREBY DECLARE THAT THE INFORMATION GIVEN BY ME ABOVE IS TRUE AND BINDING TO MY
CONSCIENCE.

…………………………………………. …………………………….                                                  ………………….. …


Name in Bold Signature                                                 Date
D. REFERENCES:

Reference 1:

Full name: ………………………………………………………… Id Nr: ……………………………………………….

Relationship: ………………………………………………………….

Contact Details:

Work: ……………………………….. Home: ………………………….. Cell: ………………

E-mail: ………………………………………………………………………

Reference 2:

Full name: ………………………………………………………… Id Nr: ……………………………………………….

Relationship: …………………………………………………….

Contact Details:

Work: ……………………………….. Home: ………………………….. Cell: ………………

E-mail: ………………………………………………………………………

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