Financial Support Office Undergraduate Scholarship Application Form Page 10

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Section 9 l Declaration
9.1 I have provided all details required and I confirm that the information provided in this application is, to the best of my knowledge,
true and correct. I undertake to notify the School’s Financial Support Office of any changes in my circumstances without delay.
I understand that false information will invalidate this application.
9.2 I give my permission for the information provided in this form (and the supporting documentation) to be shared with scholarship
donors if they request it.
9.3 I have read the criteria of the scholarships for which I wish to be considered and the relevant Guidance Notes. I confirm that I have
enclosed or have arranged to send all required supporting documentation.
Signature
Date
Please keep a copy of this form for your records. The Financial Support Office is not able to provide copies.
Please return to: Financial Support Office
LSE
Houghton Street
London WC2A 2AE
You will be sent an email acknowledgement of your application.
Checklist
Sections 1-9 completed
Evidence of your own income
Evidence of parental or partner/spouse income
Evidence of obligatory payments
Academic reference attached
OR
Academic reference being sent separately to the Financial Support Office
Name(s) of referee(s)
Evidence of any exceptional costs (eg, high medical bills) affecting you or
your household (eg, medical certificates and associated bills)
Please refer to the Guidance Notes for more information about appropriate
forms of supporting evidence.

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