APPLICATION FORM Stenden University Emergency Fund - iStenden

APPLICATION FORM 1Stenden University Emergency FundNBApplications for loans and donations from the Student Emergency Fundare submitted for advice via the student counselling department to theProfile Fund Committee. The student counselling department will alsoadvise on the application before it is submitted to the Profile FundCommittee.The Profile Fund Committee will refer the application, with therecommendations on the decision, to the ESR director or, in his absence,to his deputy.Academic year 2013/20141 The information provided will be treated confidentially.1

the normal costs of studying and living expenses. This is based on the amount ofthe ‘basic grant for living away from home’ (DUO).The student counselling department submits:1. A written explanation of the application and the accompanying advice of thestudent counsellor.2. A proposal for the repayment scheme, drawn up by the student counsellor inconsultation with the applicant.The Profile Fund Committee submits:1. The written advice of the Profile Fund Committee on the application.4. Signature:By signing below I confirm that I have truthfully completed this form withthe information provided.If details needed for the assessment of your application have been omittedand/or questions have not been answered truthfully, all claims for theprocessing of your application will be null and void.Date: ……………………………Signature: ……………………………………………1. Collection point for the application and accompanying appendices:Send this form with ALL appendices to:Directeur ESR Stenden Hogeschoolp/a secretariaat ESRPostbus 12988900 CG Leeuwarden3