Bursaries

Phone

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PART 1 –PERSONAL DETAILS

Surname:

First Names:

Gender:

Title:

I.D. Number:

Population Group:

Nationality:

Other:

Home Address:

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

Municipality:

Postal Address (if different from your home address)

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

Contact Details

Cell phone:

Alternative number:

Telephone:

E-mail address:

Next of Kin

Name:

Relationshihp with Applicant:

Address:

Cell:

Email:

PART 2 – APPLICATION DETAILS

State the career you wish to follow:

What Qualification are you currently studying, or do you intend to study?

Name of proposed University/ University of Technology:

Have you applied to other companies for a bursary?

If yes, state which company(is) and what it covers:

PART 3 – HIGH SCHOOL EDUCATION

Name of High School

Years

Highest Grade Passed

Please state your results for Grade 12

Subject

% Obtained

Achievement level

PART 4 - TERTIARY EDUCATION

Current

Name of University/Technikon:

Current year of study:

Student Number:

Year commenced:

Degree / diploma course:

Have you previously attended University / University of Technology?

Name of University / University of Technology:

Student Number:

Degree/diploma course:

Year commenced:

Have you repeated any year of study during your current or previous tertiary study?

If yes, state year, date, and reason:

Examination results: ATTACH PROOF OR RESULTS

Drop files here or

Max. file size: 256 MB.

PART 5 – APPLICANT’S ESSAY

Write an essay of 100 - 150 words to motivate your application.

PART 5 – DECLARATION

Signature

Date Signed

2025 Bursary Application Form