External Study Bursary Application Vorm 2023_2024

BERGRIVIER MUNICIPALITY
EXTERNAL
PERSONAL DETAILS OF APPLICANT
Surname
First Name
Date of Birth
Identity Number
Student Number(If available)
Equity Group
(Mark appropriate block anX)
Black Coloured Indian White
Disability (pleaseprovide proof)
Home Language
Marital Status
Home Address
Code
Home Tel Number

Cell Number
E-mail address
QualificationPARENT/GAURDIAN DETAILS
Name andSurname ofFather
Name andSurname ofMother
ID Number ofFather
ID Number ofMother
Address
OCCUPATION
Father
Mother
Guardian
QUALIFICATION
Indicate current or intended course which you will be studying towards in2023(e.g. National Diploma: Human Resources, BA, B Com (Accountancy)

Name of Institution:
LEVEL OF STUDY
Description Definition Mark appropriate block with an X
1st Year Student You will beenrolling forthe first time atinstitution
Senior Student You arecontinuing(i.e. 2nd or 3rdyear)
Final year student You will writeyour finalexamination inNovember tograduate thefollowing year
Post GraduateStudent
You will beregistered forqualification inthe year ofapplication
FUNDING
Please provide a quotation of the actual cost of your studies.

SIGNATURE OF APPLICANT
DATE
SIGNATURE OF PARENT/GUARDIAN
DATE
NOTES AND INSTRUCTIONS FOR COMPLETION  
? INCOMPLETE APPLICATION FORMS WILL NOT BE ACCEPTED (this includes forms with missing documents);  
? No late submissions will be accepted; ? The municipality does not accept responsibility and will not be held liable for any 
applications which were undelivered or missing; 
? E-mailed applications will not be accepted; ? The closing date for applications is 27 October 2023; ? Only full time students studying towards a degree/ diploma at a Tertiary Institution may 
apply; 
? A senior student must have passed the previous year's studies to qualify for a bursary;  Please attached the following documents:  Mark appropriate block with an X  
Prescribed bursary application form    
Proof of disability (if applicable)   
Certified copy of South African identity document   
Proof of monthly household income (salary or pension slip if applicable, affidavit if unemployed.) 
Proof of residence with Bergrivier municipal area    

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