DMR 223

APPLICATION FOR A FULL-TIME STUDY BURSARY FOR GIRL

LEARNERS IN SOUTH AFRICA

INSTRUCTIONS: FOR SOUTH AFRICAN GIRL LEARNERS SCHOOLING IN RURAL AREAS.

1. Please complete this form by hand using readable block letters,

2. Mark appropriate blocks with an X,
3. Application forms not correctly and fully completed will prejudice the applicants chances of obtaining a
bursary,
4. Please attach certified copies of ID document, grade 11 and/or 12 subjects and symbols on school
letterhead),
5. Please complete section D fully as motivation for a bursary and attach any supporting documentation,
6. Applicants with less than level 6 (Higher Grade) in pure Mathematics and Science will not be considered,
7. Bursaries are only intended for girl learners from the rural areas as they are faced with limited
opportunities, and to enhance transformation of the mining and mineral fields,
8 Please note the bursaries are dependent on the mining and mineral sector requirements,
9. It is your responsibility to apply for admission at any South African university,
10. Bursaries will be allocated for the year following the one in which the application is received,
11. The closing date for applications is 25 November 2016.
12. Submit application form with attachments to: The Director: Ms Nondumiso Zulu, The Department of
Mineral Resources, Trevenna Campus, 70 Meintjies Street, SUNNYSIDE, OR post before closing date to
Private Bag X59, ARCADIA, 0007 OR Fax to 086 710 1769 OR Email to nondumiso.zulu@dmr.gov.za
13.For any enquiries call Tel: 012 444 3860.

A. PERSONAL PARTICULARS OF APPLICANT

1. Surname............................................................ 2. Title..................
3. First Names..........................................................................................................
4. Residential address 5. Postal address
.............................................................. ..
.. .....
............................................................. ..
..
Postal code ............................... Postal code ...
6. Province ...
7. Telephone Number (H) 8.Cellular Number..

9. ID Number

10. Race Group African Coloured Indian White

11. Gender Female Male

 B. EDUCATIONAL PARTICULARS OF APPLICANT

12. Have you applied for admission to any South African University? Yes No

13. Provide student number(s) if answered yes above

14. Name(s) of tertiary institution(s) applied 1.

2.
3.

15. Have you completed grade 12? Yes No

16. Name of school

17. Subjects Passed

Subjects Symbol HG/SG

18. Select fields study

Mining Engineering
Geology
Rock blasting
Electrical Engineering (Heavy current)
Mechanical Engineering
Chemical Engineering
Environmental Science
Mine surveying
Metallurgy

C. BURSARY PARTICULARS

2
19. Are or were you a recipient of another bursary? Yes No

20. If YES until which year? .............

22. Are or were you in receipt of a study loan? Yes No

23. If YES to any of the above, what is the name of the organisation........................................

D. GENERAL

24. Provide motivation for your application:

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E. DECLARATION

25. I .... (full names)

declare that the above particulars are complete and correct.

............................................
Signature of applicant

Date.