Kingston College Bursary Fund Application Form Guidance

(1)

Kingston College 16-19 Bursary Fund Application Form Guidance

16-19 Bursary Fund 2015-16 Application Form

Please note: * means you must provide evidence to confirm this information. Your application will only be considered when you have completed and signed this form and provided evidence to confirm eligibility and show financial need.

Personal Information

Title: First Name: Surname:

College ID No: Email address:

Home telephone: Mobile telephone:

Date of Birth*: Age on 31^st August 2015:

Address*:

Post code:

Please circle/state who you live with

Your parent/s Your guardian Your partner On your own A friend

Other

Please tick to confirm your residential status in the UK 1.UK or EU/EEA citizen

and have lived in UK for at least 3 years

2.’Settled Status’/ Indefinite Leave to Enter or Remain/

Right to abode in UK

3.Refugee or Humanitarian Protection

4.Asylum Seeker

If you have ticked box 2,3 or 4 you must provide a Home Office letter or passport to prove your residency status Course Information

Course Title: Tutor:

Full-time: Part-time: Hours and days if part-time:

Course start date: 1 year

course

2 year course

Do you have your own bank account? Yes * No * If not, you will need to open a bank account in your own name as Bursary funds must be paid by BACS into your own account.

Bank Details for Payments (this Bank account must be in your own name) Your Name as it appears on your bank Account:

Sort Code:

(6 digits):

Account Number:

(8 digits) Type of Financial Support Applied for:

Please indicate whether you are applying for the Full 16 - 19 Bursary Fund or the Standard 16-19 Bursary Fund

€ Full 16 - 19 Bursary Fund

To apply for the Full 16 - 19 Bursary Fund you must fall into one of the categories below and you must provide evidence of your status. Please indicate which applies to you:

€ You are in care

€ You are a care leaver

€ You are in receipt of Income Support or Universal Credit (in your own right)

€ You are in receipt of both Employment and Support Allowance (ESA) and Disability Living Allowance (DLA) in your own right

(2)

€ Standard 16-19 Bursary Fund

To apply for the 16-19 Bursary Fund you must provide evidence of your household income being less than

£25,000 per year.

If applying for the Standard 16-19 Bursary Fund please indicate which tier applies to you:

€ Tier 1 Funding (Household income of up to £16,190)

• Travel Contribution: Distance/ Postcode based travel contribution

• Meal Contribution: Free College Meal (where eligible). Meal contribution of £2.41 per College day.

• Books/ Stationary/UCAS Student Payment Contribution: Contribution of £150

• Course Specific Materials Contribution: Up to a maximum of £50 for course specific materials (i.e. Art)

• Course Specific Kit Contribution: 100% of kit costs but only up to a maximum of £500

• College Trips Contribution: We may be able to make a contribution towards course related trips. Please include details of the trip and associated costs with your application.

• Childcare: If you are a young parent (under 20) when you start your course, you can apply to Care To Learn for support with childcare costs.

€ Tier 2 Funding (Household income of £16,191- £20,817)

• Travel Contribution: Distance/ Postcode based travel contribution.

• College Trips Contribution: We may be able to make a contribution towards course related trips. Please include details of the trip and associated costs with your application.

€ Tier 3 Funding (Household income of £20,818- £25,000)

• Travel Contribution: Distance/ Postcode based travel contribution.

• College Trips Contribution: We may be able to make a contribution towards course related trips. Please include details of the trip and associated costs with your application.

Free College Meals

Free College meals will be provided for 16-18 year olds whose parents are on a means tested benefit and household income is no more than £16,190 per year and to19-25 year olds who have a Learning Difficulty Assessment (LDA) or Education Health and Care Plan (EHCP).

Eligibility Criteria:

-‐ Income Support

-‐ Income based Job Seekers Allowance (JSA)

-‐ Income related Employment and Support Allowance (ESA) -‐ Support under part V1 of the Immigration and Asylum Act 1999 -‐ A Guarantee element of State Pension Credit

-‐ Child Tax Credit (provided they are not entitled to Working Tax Credit) and have an annual gross income of no more than £16,190 as assessed by Her Majesties Revenue and Customs

-‐ Working Tax Credit run on- paid for 4 weeks after you stop qualifying for Working Tax Credit -‐ During the initial roll out of the benefit, Universal Credit

This means that Working Tax Credit is not a qualifying benefit for Free College Meals and a parent/ student in receipt only of Working Tax Credits is not entitled to a free meal.

(3)

Do you meet the eligibility criteria for Free College Meal? Yes * No *

Additional Information

Please use this space to provide us with additional information about yourself to support your application.

Please specify how you travel to College and how long your journey takes.

Evidence

To apply for the Full 16 - 19 Bursary Fund you must fall into one of the categories below and you must provide evidence of your status.

Status Evidence Y/N

You are in care Letter from your Social Worker/ Social Care

You are a care leaver Letter from your Social Worker/ Social Care

You are in receipt of Income Support or Universal Credit (in your own right)

Letter confirming benefit no more than three months old

You are in receipt of both Employment and Support Allowance (ESA) and Disability Living Allowance (DLA) in your own right

Letter confirming benefit no more than three months old

To apply for the Standard 16-19 Bursary Fund you must provide evidence of your household income being less than

£25,000 per year.

Please indicate ALL benefits/ Income your household receives. Please also provide evidence of this with your application (photocopies only).

* Please note that if you are able to provide the specified evidence of Child Tax credit or Working Tax credit you are not required to provide any further evidence.

Name of Income / Benefit Y/N Evidence Needed (photocopies) Y/N

*Child Tax Credit All pages of most recent Tax Credit Award Notice or recent Bank Statement showing payment

*Working Tax Credit All pages of most recent Tax Credit Award Notice plus Parents/ Carers payslips for the last three months

Income Support

Recent Bank Statement showing payment or letter confirming benefit (no more than three months old)

Employment Support Allowance (ESA)

Recent Bank Statement showing payment or letter confirming benefit (no more than three months old)

(4)

Universal Credit Recent Bank Statement showing payment or letter confirming benefit (no more than three months old)

Job Seekers Allowance (JSA) Recent Bank Statement showing payment or letter confirming benefit (no more than three months old)

Pension Credit Recent Bank Statement showing payment or letter confirming benefit (no more than three months old)

Employment Parents/ Carers Payslips for the last three months

Self-Employment Most recent Self-Assessment Tax Calculation (Gov.uk assessment) Other Income

Please note that Bank Statements may be required as additional evidence.

If you are applying for support with travel costs please provide a print out from https://www.tfl.gov.uk/plan-a-journey of your journey to College by bus. This is required to assess your eligibility.

If you are applying for support with costs of Kit or Course Related Materials please provide the kit/ Materials list and associated costs. If you are applying for support with costs of Trips please provide the trip details and associated costs.

Declaration/Agreement

I declare that the information given in this application is full and correct to the best of my knowledge.

I confirm that all taxable income sources are declared.

I understand that giving false or incomplete information may lead to legal action being taken against me to recover funds paid and that it may jeopardise my continuing payments from this and subsequent applications.

I agree to inform the College immediately if any of the details provided on this form change, particularly change to household income or change of bank details.

I understand that bursary payments will only be made to students who meet the eligibility criteria, maintain a minimum of 90% attendance and have positive Tutor reports.

I understand that the bursary is to support me to attend College and with College related costs and that if I leave College or do not attend College the Bursary payments will not be made and any equipment purchased on my behalf must be returned to the College.

I understand that Bursary Childcare payments will not be made for Holiday periods.

I understand that I am responsible for informing the Jobcentre Plus or Benefit Agency of any funds I have received through the College Bursary Fund.

By signing this application you are agreeing to the terms set out above and you are signing to confirm that you agree to allow the information contained on the form to be shared with staff at Kingston College. Your data protection rights are not affected.

Signed: ………... Date: ………...

Application Form Check List For Staff use Staff notes:

Travel Route and Means of Travel:

Number of dependents/ siblings in household:

Does the student qualify for the Full Bursary?

Completed Bank Details Y / N Kit/ Course Materials List and Costs Y/N Evidence of household Income Y/ N Course Trip Details and Costs Y/N Free College Meals Eligibility Y/N TFL Bus Travel route print out Y/N

(5)

Evidence of Status (if Full Bursary) Y/N

The application form CANNOT be submitted until ALL relevant documents have been supplied and the form is fully completed

Support Staff:

You are signing to confirm the application and attached documents are received

Staff signature:

Staff initials:

Date:

Administration:

Date full application received:

Approved: Y/N

Date outcome letter sent to student: