information sheet and application form - Yeovil College

More documents

Recommendations

Info

Learner’s Financial RequirementsDo you live over 3 miles (4.8km) from college? Yes NoHow many days per week are you expecting to attend college?Do you feel you will be prevented from participating in learning due to the cost of transport to college? Yes NoPlease provide information about the costs you expect to have this academic year:Please enclose receipts or invoices as evidence of expenses, these must be provided for payments to be made.Learner’s Expenses Details Amount (£)TransportQualification FeesBooks and EquipmentTripsOtherHousehold StatusTick as applicable to the learner Living independently Living with parent(s) Living with spouse/partnerOther (please state)Personal and Household Income (MUST be included in order to proceed with assessment)Please provide details of household income (not including parental income). Tick all that apply and enclose photocopies as evidence. I live with my parent(s) and receive no income I enclose a copy of 2012/2013 P60(s) for myself and/or my partner I enclose a copy of audited accounts (2012/2013) for myself and/or my partner whose self-employed I enclose a copy of the 2013/2014 Tax Credit Award Notice(s) for myself and/or my partner I enclose a copy of benefit entitlement letter(s) for myself and/or my partner. Examples of benefits: Job Seekers Allowance (JSA) Guaranteed Element of State Pension Credit Employment Support Allowance (ESA) Housing Benefit Income Support (IS) Council Tax Benefit Incapacity Benefit Child Benefit Universal Credit Personal Independence Payment (PIP) I enclose evidence of all other household income e.g. maintenance payments highlighted on bank statementsIf you have any queries please contact Student and Customer Services:Telephone. 01935 423921
Learner and Parent/Guardian DeclarationI/we certify that the information given is, to the best of my/our knowledge and belief, correct.I/we understand that it may be necessary for the College to use the information given, or share the informationprovided, with other organisations to prevent and detect fraud.I/we understand that all information and documentation included with this form will be kept in accordance with the DataProtection Act and will be kept for a period of at least 7 years.I/we understand that should the learners attendance fall below 80% payments will not be made for that month.Learner’s Signature:Date:Childcare DeclarationChildcare will only be awarded to fund Childcare with a provider who is Ofsted registered.Payments towards childcare costs will only be made for timetabled sessions, but can also include time spent oncompulsory work placements and retainer fees.Payments for your childcare costs will be paid in arrears on production of a monthly invoiceCheques will be raised and made payable to the childcare provider. It is the learner’s responsibility to collect thecheque and pay the childcare provider the remaining balance. Our agreement is with the learner and not the childcareprovider.I understand that should the learner’s attendance fall below 80% payments will not be made for that month.It is your responsibility to inform us of any changes to your timetable or childcare arrangements.I understand the terms and conditions of the application and hereby agree to them (otherwise the application becomesvoid). I also understand that the completion of this application does not automatically entitle me to financial assistancewith childcare and I will be contacted with the outcome of my application.Learner’s Signature:Date:Learners can return this form to Student and Customer Services or return by postto the address below:(Please remember to enclose evidence otherwise we can not assess yourapplication)19+ Adult Discretionary Support FundStudent and customer ServicesYeovil CollegeMudford RoadYeovilSomerset BA21 4DRBA21 4DR
Page 1 and 2: 19+ Adult Discretionary Support Fun
Page 3: ForCollegeDate Received:Student PC:

information sheet and application form - Yeovil College

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?