Sample Application Form Guidance Notes - Advice and Counselling ...

1
Access to Learning Fund Guidance Notes 2007/08
Application Deadlines
Applications should normally be submitted at least 4 weeks before the end of your
academic year but if you are a continuing student and have exceptional circumstances,
you can apply until 1 August 2008.
Documentation
It is important that you send supporting documentation with your application form. The
Student Awards Office cannot usually accept original documents and you are therefore
asked to supply legible photocopies. In certain circumstances we may contact you
separately and ask for the relevant original documents. Applications that do not have
supporting documents are incomplete and cannot be processed. We will return these
forms to you, which will delay your application.
How to complete the application form
Answer all questions on the application form by printing clearly in black ink or by ticking
the appropriate boxes. If you need help to complete the form please make an appointment
to see a Welfare Adviser either by calling in person at the Advice and Counselling Service
(Ground Floor, Geography Building) or by phoning 020 7882 5175 or by visiting the
website www.welfare.qmul.ac.uk.
Part 1: Personal Details
Complete all sections.
Age – as at 1st September 2007.
Address – please put the address (include the postcode) that is to be used for
correspondence. We will write to this address to let you know the outcome of your
application.
Telephone Number – please include the area code and include your mobile phone number
if you have one.
Part 2: Course Details
Complete all sections.
Part 3: Confirmation of Attendance
If you are based at Mile End, please ask your Academic adviser/personal tutor or
Academic Departmental Office to confirm your attendance. If you are based at
Whitechapel please ask the staff in the Student Office at Whitechapel to confirm your
attendance.
Please note, you do not have to disclose any of the information given beyond this section
of the form to your Academic Department and if you do not wish them to see it you may
ask them to sign it before completing the remainder of the form.
If you are unable to have this section signed because you are out of attendance or
interrupting your studies, please explain your situation in Part 8 of the application form.

Part 4: Dependants
Give details of any children and/or adults who are financially dependent upon you.
Part 5: Disability/Special medical needs
Complete this section if relevant.
Disabled students, especially those with dyslexia, may wish to apply for a preliminary
diagnostic test, prior to applying for a Disabled Students Allowance. Help in meeting this
cost may be provided through Access to Learning Funds. Please contact the Disability and
Dyslexia Service for advice on 020 7882 2757.
Part 6: Income/Expenditure
Complete both income and expenditure sections.
It is important that you fill in these sections as accurately as possible. Please state whether
these figures are weekly, monthly or annual. Only put in a total amount if all figures are
either weekly or monthly or annual.
Please estimate costs of essential items where you are unable to make payments because
of insufficient income.
Part 6A: Student’s income
Please make sure that you include your income from all sources.
Maintenance Loan
Please put in the full amount of loan you are eligible to receive – you can check this on
your final notification letter from Student Finance Direct.
You must have taken out the full amount of loan you are eligible for before receiving help
from the Access to Learning Fund.
If your parents have refused to complete a financial assessment form and you are
therefore only able to take out the non means-tested element of the loan, this does not
make you ineligible for the Fund but we may need further information.
Part 7: Expenditure
Please include all expenditure that you (and your partner/children) have and state whether
weekly, monthly or annual. When considering your application a set figure will be used for
certain elements of your expenditure, this is known as composite living costs and the
amount designated will depend on your circumstances.
Part 8: Exceptional Circumstances
You do not need to have exceptional or unforeseen circumstances to apply, but if you do,
you may get further financial support so it is important that you tell us about them. If you
would like individual advice about what you might include in this section. Contact the
Advice and Counselling Service.
Part 9: Method of Payment
Please complete the BACS Payment details on the back of this form so that any payment
can be made directly into your bank account. If you prefer to be paid by cheque or your
payment to be made to a third party, e.g. accommodation, please indicate this on your
form.

Part 10: Declaration
Please tick all the relevant boxes that apply to your circumstances and remember to sign
and date your application form at the top of page 7.
Part 11: Documentation Checklist
On page 7 of the form is a list of documents you will need to submit with your completed
application form. If any evidence is missing we cannot assess your application. In addition
to this, you may need to send in further photocopies of documents specific to your
situation. For example, if you have to travel back to your parental home to care for an ill
relative, you could supply evidence of travel tickets. If you have any questions on what
documents you need to produce please contact:
Student Awards Office on 020 7882 3086/5574/7610
If you require this form in an alternative format please contact Lesley Green on 020 7882
7610.

APPLICATION FOR PAYMENTS TO BE MADE BY BACS
Surname: Initials: Title:
BLOCK capitals
Student No:
Address:
Bank name and address:
Post code:
Bank account name:
Bank account number:
Sort Code:
Signature:
Course:
Department:
Date:
FINANCE OFFICE USE
Date Changed to BACS:
Input by:
Supplier Reference: