BURSARY APPLICATION

Application forms will not be accepted

through fax or email.
Please post forms or deliver by hand.
Application forms are available from 1 July each
year and may be collected or posted on request.

Tel: 021 685 1025

FOR OFFICE USE ONLY

RETURN APPLICATION FORM TO:

5 Long Street, Mowbray, 7700,
W. Cape, South Africa

RETURN BY
31 OCTOBER
(the year before you start your studies)

IMPORTANT INFORMATION

ELIGIBILITY
Only South African citizens who are resident in the Western Cape are eligible.
Students who are in Grade 12 going to study for a first degree, diploma or higher certificate.
APPLICATIONS
Applications may be made for a University OR University of Technology in the Western Cape only.
Applications for private institutions or FET Colleges are not accepted.

In view of large numbers of applications, only successful candidates will be notified. This will be
done by the end of February.

AWARDS

Awards are made by a Selection Committee meeting in late January and are based on merit and
financial need. Where funds are limited priority is given to students who are financially needy and
who are from less advantaged communities.

Awards are variable and cover a percentage of the cost of tuition and books.
ASSET bursaries are not repayable.
Bursars are able to access loans to cover the balance and any other costs through a partnership
with NSFAS (National Student Financial Aid Scheme.) Loans through NSFAS are repayable but up
to 40% may be converted to a bursary depending on successful results.
Bursary funds are paid directly to tertiary institutions.

IMPORTANT DOCUMENTS TO INCLUDE WITH YOUR APPLICATION

Please send certified copies of documents 1, 2 and 3.
Check

1.

Identity Document (ID)

2.

Final School Certificate (if available new applicants only)

3.

Latest results from school or tertiary institution (if finals not available)

4.

Documentary evidence from all income earners in your home (see Section B)

You should submit a certified copy of final results as soon as they are available.
Please print clearly and check that you have completed the following application form
(4 pages) in full.

ASSET BURSARY APPLICATION FORM

Application Number:

Page 1 0f 4

Office Use only

SECTION A: PERSONAL INFORMATION

TO BE COMPLETED BY ALL APPLICANTS
Title

Mr

Mrs

Ms

Place of Birth
Date of Birth

Day

Surname

ID Number

First Names (in full)

Telephone/Home contact

Month

Year

Cell phone

Home Address

Postal Address (if different from home address)

Code

Code

E-mail address:

SECTION B: FAMILY DETAILS

TO BE COMPLETED BY ALL APPLICANTS

Write on the back of this page if you need to give any other details not covered in this section.

How many people live in your house, including yourself?

No. of learners in family still at school (Grade R Grade 12), including yourself
No. of students in family studying at University or other Tertiary Institution, including
yourself
Name of Parent(s)
or Name of Guardian

FAMILY INCOME -Confidential

List below all the people in your family/household who receive an income.
Surname
Initials Approx
Relationship to you e.g.
Age
Mother, Sister,
Uncle/Guardian

Occupation
(including self
employment)

Monthly
Income

N.B.
Send copies only, (not originals) of pay slips, or pension advice. If any working person does not
get a pay slip, they should get a sworn statement (an affidavit) from the nearest police station stating
how much that person earns.

ASSET BURSARY APPLICATION FORM

Page 2 0f 4

SECTION C: SCHOOL DETAILS

TO BE COMPLETED BY APPLICANTS WHO ARE WRITING SENIOR CERTIFICATE THIS YEAR AND THOSE
WHO HAVE PREVIOUSLY WRITTEN BUT HAVE NOT YET ATTENDED A TERTIARY INSTITUTION

1.

Name of school ________________________________________________________

2. Are you writing your Senior Certificate this year? (Yes/No) ______________________
3. If No, what year did you write your Senior Certificate? _________________________
4.

If you wrote before this year, are you upgrading your marks? (Yes/No)_______________

SECTION D: PLANS FOR TERTIARY STUDIES NEXT YEAR

NB: Applications for Private Institutions are not accepted
TO BE COMPLETED BY NEW APPLICANTS ONLY

1.

Name of institution where you intend studying _________________________________

2. Have you applied to this institution (Yes/No)? __________________________________

a. Have you applied to any other institution(s) (Yes/No)? __________________________
b. If yes which one(s)? ___________________________________________________
3. What Degree/Diploma/Certificate Course do you intend studying? (Write out in full
e.g. BSc Engineering, ND Information Technology, NHC Accounting)
st

1 Choice

________________________________________________________

2nd Choice

________________________________________________________

4. Length of Course? (Circle the No. of years)

1
2
3
4
5
6
5. Why have you chosen this Degree/Diploma/Certificate Course and what do you intend doing
when you have completed it?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

ASSET BURSARY APPLICATION FORM

Page 3 0f 4

SECTION E: APPLICATION FOR BURSARY RENEWAL

TO BE COMPLETED BY CURRENT BURSARS APPLYING FOR A BURSARY RENEWAL

1.

Name of Institution _____________________________________________________

2. Course for which you are currently registered (Write out in full
e.g. BSc Engineering, ND Information Technology, NHC Accounting)
_____________________________________________________________________
3. Student number

4. Year of study (Circle year currently registered)

1

5. Enter your most recent exam results below:

Month

Year

Subject

% or symbol

6. Course for which you are registering next year (Write out in full
e.g. BSc Engineering, ND Information Technology, NHC Accounting)
______________________________________________________________________
Additional Bursaries/Loans
1.

Were you awarded any other bursaries, loans or scholarships in the present year or last year?
(Yes/No) ____________________
If yes, complete the following:
Year

By whom granted

Value

Loan or Bursary

ASSET BURSARY APPLICATION FORM

Page 4 0f 4

SECTION F: MOTIVATION
TO BE COMPLETED BY ALL APPLICANTS

Motivate your application by writing something about yourself, and your goals in life.
If you are applying for a bursary renewal, write about the course you are studying and your
experiences as a student so far.

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

SECTION G: CONTACTABLE REFERENCE

TO BE COMPLETED BY ALL APPLICANTS
Give details of one person (except your School Principal) who knows you well and can be contacted for a reference.

Name and title (Mr. / Mrs. / Ms.) ___________________________________________________

Occupation: ___________________________________________________________________
Address

Telephone
Cell phone

Code

SECTION H: DECLARATION
TO BE COMPLETED BY ALL APPLICANTS

I hereby declare that the information given in this application is correct. I understand that if the
information is found to be incorrect and does not comply with the conditions of ASSET, the support
may be discontinued with immediate effect and legal action may be instituted.
Signature of applicant: _________________________________________________________
Assisted by Parent/Guardian: _______________________________if applicant is under 18 years.
Signature of Parent/Guardian: ____________________________________________________
Date:

_______________________________________________