PPS Bursary Application Form

PPS Bursary Application

for professionals

for 4th year or post-grad degree

since 1941

PERSONAL PARTICULARS Title:

First name:

Gender: Male:

Surname:

Female:

ID/Passport number (if no ID):

Please indicate your race group: Black

Indian

Mobile number:

Coloured

White

Other

Specify ....................................

Email:

Twitter handle:

Facebook url: (eg. @johnsmith:)

(eg: www.facebook.com/johnsmith:)

ACADEMIC DETAILS Student number: Current university:

Current faculty:

Current academic year of studies:

1st

2nd

3rd

4th+

Degree currently being studied: Anticipated year of completion of the abovementioned degree: 2012

2013

2014

2015

2016

Degree for which the bursary is requested: University at which you will be completing this degree: Profession you intend pursuing: Are you a member of PPS?

Yes

No

Average academic results: 1st year:

%

2nd year:

%

(if applicable)

3rd year:

%

(if applicable)

4th year:

%

(if applicable)

= Total average:

%

Number of distinctions obtained to date for current degree: Scholarship amount required: R Attach the following to your application form: • • • • •

Outline your ambitions for the future and why you think you deserve this award (max 300 words in MS Word) Certified copies of all available examination results, including the most recent (June) or progress report A declaration of your own and/or your family’s financial position (copy of an affidavit) Statements of your student account confirming no outstanding fees for the current or previous years Copy of ID / Passport

Please note: no reference letters are required from lecturers. Please scan & fax back to (011) 644 9629 or email to [email protected] Signature:

Date:

Terms and Conditions - Applicant is registered at a South African university. - Applicant will be registering for a 4th academic year or post-graduate degree in 2012, in the field of engineering, commerce, science or medicine. - Applicant has an exceptional academic record with an average academic result of 75% or above. - Applicant is a citizen or permanent resident of South Africa. - Bursaries are awarded on a financial need basis and cover tuition fees and books. - Judges’ decision is final and no correspondence will be entered into. - Applications close on 15 January 2012. - Successful candidates will be informed in writing (email) by 30 January 2012. The Professional Provident Society Holdings Trust No. IT 312/2011 (PPS) is a Registered South African Trust.