Financial Support Application Form 2015/16 - North Notts College

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Student.ID
Date.Received
Financial Support
Application Form 2015/16
First.Name
Surname
Date.of.Birth
Age.on.1st.September.2015
Address........................................................................................................................................................................................
..................................................................................................................... Post.Code...............................................................
Home.Telephone.Number
Mobile.Number
Email
Course
I.would.like.to.apply.for:.Please.tick.(3)
Childcare
Learner.Support.Fund.(19+)
College.Bursary.(16-18.year.olds)
Travel
Free.Meals.
24+.Advanced.Learning.Loans.Bursary
Please indicate your personal circumstances
I.have.a.LA.Care.Order
I.have.an.EHC.Plan
I.live.with.parents/carers
I.live.with.a.partner/spouse
I.live.on.my.own.
I.receive.DLA/PIP.and.ESA
Relationship.to.you.eg.mother,.carer,.step-father,.brother,.sister,.boyfriend,.friend
Name.
Relationship
Name.
Relationship
I/We.declare.that.the.information.we.have.given.in.support.of.this.application.is.correct.and.complete.to.the.best..
of.my/our.knowledge.and.belief.and.will.notify.North.Notts.College.of.any.change.in.circumstances.
I/We.understand.that.this.information.will.not.be.shared.with.third.party.organisations.
I/We.understand.that.non-attendance.and.non-compliance.with.the.College.Charter.may.result.in.loss.of.financial.
support..I.understand.that.it.is.my.responsibility.to.advise.the.Benefits.Office.of.any.payments.received.
Learner.Signature
Date
Parent/Carer.Signature...
Date

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