PFG1 - Student Awards Agency For Scotland

Application forPart-Time Fee Grant2013 - 2014PT1Who should fill in this form?You should fill in this form if you are studying part-time for an HNC, HND, degree course, Professional Development Award (PDA) ora Continuing Professional Development course (CPD) at SCQF level 7-10 (including PGDEs but excluding all other postgraduatequalifications) and completing between 30 and 119 SCQF credits per academic year.Instructions for filling in the formPlease fill in this form in BLACK INK. Please do not mark any other areas on the form.You must apply every year for support. You should only make one application each academic year.To help you fill in this form, please read the step-by-step instructions in the separate ‘Notes to help you with your Part-Time FeeGrant application (PT2)’.IMPORTANT: You must apply to us as early as possible to make sure that we pay your Part-Time Fee Grant to yourcourse provider on time. Your application for support must be with SAAS no later than three calendar monthsafter your course starts. If we receive your application later than three calendar month after your course startswe will reject your application. .If you have any questions please call our helpline on 0300 300 3137.Data Protection StatementData Protection Act 1988 and fraud prevention – This Agency has a duty to protect the public funds itadministers, and to this end will use and share that information with other organisations for the purposes ofensuring you remain eligible for support. We will also use the information you have provided on this form forthe prevention and detection of fraud and will also share this information with other bodies responsible forauditing or administering public funds for these purposes. We may request information from otherorganisations for the purpose of ensuring that you remain eligible for support and that the level of supportawarded is correct. You should read the full SAAS privacy statement and note on fraud on our website.Section AYour personal detailsA.1 Have you ever applied for an award from ILAScotland or SAAS for a part time course?YesXNoXCross (x) one box onlyA.2 If you answered ‘Yes’ to question A.1, pleasegive your ILA or SAAS reference number orboth (if applicable)ILA reference numberSAAS reference numberA.3 Are you receiving support from any othergovernment funding schemes e.g. ILA 200,Modern Apprenticeship or SAAS, for a fulltimecourse?Yes No Cross (x) one box onlyX XA.4 If you answered ‘Yes’ to question A3, pleasetell us the name of the scheme andorganisation that you are receiving fundingfrom.Page 1 of 6

Application forPart-Time Fee Grant2013 - 2014PT1Section AYour personal details (continued)NameA.5 Title MrXMrsXMsXMissXOther (please specify)A.6 First nameA.7 Last nameA.8 Date of birthD D / M M / Y Y Y YA.9 Are you MaleXFemaleXA.10 Marital status SingleMarriedXXA.11 Date you got married or moved in with your partnerDivorcedXSeparatedXWidowedD D / M M / Y Y Y YXPartner X CivilPartnershipXFull postal address of your homeA.12 Postcode (UK only)A.13 House number or nameA.14 Rest of address includingthe street, town andcountryA.15 Phone numberA.16 E-mail addressYou should now fill in section BPage 2 of 6

Application forPart-Time Fee Grant2013 - 2014PT1Section BYour residence eligibilityYou need to fill in this section if you are applying to us for the first time or you are applying to us after a break in study of oneyear or more.Personal detailsB.1 Country of Birth UKXOther (givedetails)B.2 Nationality BritishXOther (givedetails)B.3 Country younormally live inScotlandXEnglandXN. IrelandXWalesXOtherXCross (x) onebox onlyIf ‘Other’ please tell us whichcountry you normally live inRelevant dateB.4 Please say which period your course begins in 1 Aug – 31Dec 2013X1 Jan – 31Mar 2014X 1 Apr– 31Jun 2014X 1 Jul – 31Jul 2014XThe start date of the period you chose in question B4 is your relevant date; later questions will refer to it.Ordinary residentB.5 Have you been ordinarily resident in the UK continuously for threeyears immediately before your relevant date given in B.4?Yes XNo XIf ‘Yes’, go to B.7If ‘No’ got to B.6B.6 If you answered ‘No’ to question B.5, in which country or countrieshave you been living for the three years before your relevant dategiven in B.4?B.7 Have you been or will you be, ordinarily resident in Scotland on your relevant date given in B.4? Yes XNoXB.8 Will you be or were you living in Scotland for at least 12 months immediately before the1 st August 2013?B.9 If you are or were, under 25 on your relevant date given in B.4, whatis your parents address on that date?Yes XNoXB.10 If you are or were under 25 on your relevant date given in B.4, have either of yourparents been living outside the UK at any time during the three years before this?Yes XNo XB.11 If you answered ‘Yes’ to question B.10, in which country orcountries outside the UK have your parents been living for the threeyears before your relevant date given in B.4?Do I need to send in documents about my residenceIf you are not a UK national or a national of another EU member state, you must send us a copy of any documents you have from the HomeOffice that confirms your status in the UK. For example, your UK Residence Permit (UKRP), your entry clearance visa, your ApplicationRegistration Card (ARC), or your Home Office letter.You should now fill in section CPage 3 of 6

Application forPart-Time Fee Grant2013 - 2014PT1Section CInstitution and course detailsCollege or university detailsC.1 Full name of the college, university or trainingprovider you will be studying at in session 2013-2014Course detailsC.2 Full qualification level and title of your course(you must enter this)C.3 Which year of this course are you goinginto?1stX2ndX3rdX4thX5th X6thX7thX8thXC.4 When will you finish your course?M M / Y Y Y YC.5 How many years in total does your coursetake to complete?C.6 Did you receive any third party help topay for your course fees for this session?Yes X No X If yes please enter the amount.EU students (not UK nationals) studying in ScotlandC.7 Do you plan to graduate in Scotland fromthe course you are studying?Yes X No XYou should now fill in section DSection D Your IncomeHow much do you earn?You must give us evidence of any income (including nil income) or benefits that you receive.D.1 Please give us details of your gross annual income, including any replacement living cost benefits/tax credits that you are in receipt of. Pleasesee the notes to help you with your Part-Time Fee Grant application (PT2) for more information.Gross PAYE incomeNet profit from self-employed incomeIncome from private, employer’s, retirement pensionsReplacement living cost benefits, including state pension andallowances£ .£ ,£ ,£ ,D.2 If you have no income cross (x) this box (please provide evidence of this (see our notes (PT2) for more information)You training provider should now fill in section EPage 4 of 6

Application forPart-Time Fee Grant2013 - 2014PT1Section ETraining provider detailsYour training provider must fill in this section.Please note that it is the training provider’s responsibility to make sure that the person within the institution who is endorsing the application form isauthorised to do so.E.1I confirm that the student detailed overleaf is working toward* SCQF credits this session , leading to an eligible qualification atSCQF level 7-10 and is not receiving support under the fee-waiver scheme.* Please enter the number of SCQF credits in this boxE.2 The date the current course year startsor started onE.3 Total course fee charged to£student for 2013-14E.4 DateD D / M M / Y Y Y YD D / M M / Y Y Y YE.5 Course provider’s signatureCourse provider’s stampThe applicant should now fill in section FSection F Declaration and undertaking (all students must sign this)Student declarationThis award is made under the Students’ Allowances (Scotland) Regulations 2007 (as amended).• As far as I know, the details I have given on this form are complete and accurate.• I agree to give you any further information you may ask for.• I agree to tell you immediately if I do not matriculate, or withdraw from my course of study.• I will tell you immediately if my circumstances change in any way that might affect any amount I have received, or had paid on my behalf.• I understand that if I give you false information, or do not give you complete information, you may prosecute me and withdraw the support.• I agree to repay any amount I have received, or that has been paid on my behalf, which is more than the award due to me.• I have read and understand the privacy statement at the start of this application on Fraud and the Data Protection Act 1998. I consent to the use ofinformation I have provided and to the collection of other information, as set out in the privacy statement. I understand you will use this information toconfirm that I am and continue to remain eligible for an award and that the amount of the award is correct.F.1 Your signatureYou must sign hereDate D D / M M / Y Y Y YWe may prosecute you if you give false informationYou should now fill in section GPage 5 of 6

Application forPart-Time Fee Grant2013 - 2014PT1Section GFiling in the formChecklistPlease use the checklist below to help make sure you have filled in all the sections that apply to you. Give us allthe details we ask for.Signatures we need• Have you signed and dated the declaration on page 5?• Has your course provider filled in the endorsement on page 4?Sending us documentsDo NOT send us original documents, send us CLEAR PHOTOCOPIES as we destroy all documents after 30 days.Put a cross (x) in the boxes to tell us what documents you are sending with this application. You must not attachthe documents using pins or staples. Please send us a clear photocopy, do not send us originalsG.1 Evidence of income or nil income (see Notes to help you with your Part- Time Fee Grantapplication (PT2) for more information).XG.2 Evidence of income from benefits/tax credits XG.3 Evidence of residency (where applicable) XTotal number of documents enclosedNeed helpIf you have any questions about this application, please contact us before sending it to us. Please call ourhelpline on 0300 300 3137 or email us at Parttimefeegrant@scotland.gsi.gov.ukSending your form to usYour application for support must be with us no later than three calendar months after your course starts. If wereceive your application later than three calendar months after your course starts, we will reject your applicationPlease send your filled-in application form and any documents to:The Student Awards Agency for ScotlandGyleview House3 Redheughs RiggEdinburghEH12 9YTPlease make sure you use the correct postage. If you do not, there is likely to be a delay with processing yourapplication. We will not accept faxed, scanned, photocopied or email copies of your application form.Page 6 of 6