HCI Foundation BURSARY FUND APPLICATION FORM.pdf

DECLARATIONI, ……………………………………. the undersigned hereby declare that the information provided in thisapplication is to the best of my knowledge true and accurate. I hereby undertake to inform HCI Foundation ofany changes in my circumstances. I acknowledge that should I fail to inform HCI Foundation of any changesin my financial situation and continue to receive financial aid not due to me, HCI Foundation will have recourseagainst me.Signature of ApplicantDatePlease make sure the following documents are enclosed:SUPPORTING APPLICATION DOCUMENT CHECKLISTAttached?YESNO1. CERTIFIED COPY OF ID DOCUMENT2. CERTIFIED PROOF OF PARENT(S) / GUARDIAN(S) LATEST SALARY,GRANT OR INCOME3. AFFIDAVIT CONFIRMING UNEMPLOYMENT, ELDERLY, DISABLED,SICKLY DEPENDENTS4. A CERTIFIED COPY OF STD 10 / GRADE 12 (1 ST YEARS ONLY) (OR)5. A CERTIFIED COPY OF THE RESULTS FOR THE PREVIOUS STUDY YEAR(COLLEGE / UNIVERSITY / UOT STUDENTS APPLYING FOR 2 ND ORSUBSEQUENT STUDY YEAR)6. OFFICIAL LETTER OF ACCEPTANCE FROM COLLEGE / UNIVERSITY /UOT WITH REGARD TO THE COURSE APPLIED FOR7. DETAILED QUOTATION OR STATEMENT FROM INSTITUTIONINDICATING COURSE FEES FOR THE FULL ACADEMIC YEARIMPORTANT NOTICEPlease make sure that this form reaches us before the closing date. Should you still have any outstandingdocuments please inform us in writing. It remains your responsibility to submit outstanding documentstimeously in order to prevent delays to the processing of your application.The Foundation will not pursue missing information. Incomplete applications will be disqualified.The decision of the HCI Foundation is final and no correspondence will be entered into.Closing DateFriday, 15 October 2010PLEASE NOTE THAT APPLICATIONS RECEIVED AFTER THIS DATE WILL NOT BE ACCEPTED04