APPLICATION FOR BURSARY

Section/division

Form Number: CA 183-191

HUMAN RESOURCES

APPLICATION FOR BURSARY PREFERRED FIELD OF STUDY Cabin Crew Aeronautical Engineering Air Traffic Control PERSONAL DETAILS Title Mr Surname Full names South African ID No Date of Birth dd mm Population Group Black Home Address

Pilot Aircraft Maintenance Engineering

Mrs

yy

Ms

yy Age Coloured

Province

Gender Indian

M White

F

Code

CONTACT DETAILS E-mail: Contact Telephone:

Cell Phone:

EDUCATIONAL DETAILS Are you presently studying? Yes Highest grade passed Name of School GRADE 11 RESULTS Subject

No Year Province GRADE 12 FINAL OR LATEST TERM RESULTS Subject %

%

ACHIEVEMENTS

CA 183-191

21 JULY 2017

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GROSS HOUSEHOLD INCOME Below R100 000 R100 000 – R300 000

R300 000 – R500 000 Over R500 000

DECLARATION i. I declare that the statements made in this application and in the accompanying documents are true in every particular, to the best of my knowledge and belief. ii. I also understand that the bursary assessment and allocation process is competitive, and that not all applicants who meet the eligibility criteria will be awarded a bursary. iii. I understand that providing inaccurate information in this application may result in cancellation of a bursary offer, or termination of a bursary that has been paid to me.

SIGNATURE OF APPLICANT

NAME IN BLOCK LETTERS

DATE

IMPORTANT NOTICE 1. This form must be accompanied by the following documents:  A certified copy if ID Document  Latest school/matric results  Motivational letter  Proof of parent’s income 2. Incomplete applications will not be considered. 3. Submission of this application does not guarantee a bursary offer.

For enquiries or more information please contact Chwayita Majibana on 0115451371 or email at [email protected] Applications must be sent to: Email: [email protected] Postal Address:

CA 183-191

Bursary Applications Human Resources South African Civil Aviation Authority Private Bag x73 Halfway House 1685

21 JULY 2017

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