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Bursary Application Form

1.Please complete the application form in black ink.

  1. Complete one form per learner
  2. Originally certified copy ofyour IDDocument
  3. Should you have passed Grade 12 but have not commenced further studies and are still within the qualifying age, you need to provide your final Grade 12 examination results.
  4. If you are in your first year at an institution, include a certified copy of your Grade 12 examination results and current academic results.
  5. Attach proofofregistrationforthosebeyondfirstyearofstudy ( applicable for continuing students only)
  6. Attach highest qualification obtained if applicable
  7. ProofofIncome/ Affidavit (for unemployed), and certified ID copies ofparent/guardian.
  8. A motivational letter written by yourself, the applicant, stating why you should be considered for a bursary and explaining why you require funding via the bursary.
  9. Your application will NOT be considered if you do not furnish proof of the required academic results or records.
  10. Attach certified copies of the required documents at the back of the application form. Do NOT submit them separately. Do NOT send original documents.

Section A : Particulars Learner
Surname: Maiden surname (if applicable):
First name: Title (Mr. Mrs. Ms.):
Date of birth: Identity Document number:
Race : African Indian Coloured White
Other (Specify)______
Disability(underline the nature of the disability if applicable) / 01 Sight (even with glasses)
02 Hearing (even with a hearing aid)
03 Communication (talking, listening)
04 Physical (moving, standing, grasping)
05 Intellectual (difficulties in learning); retardation
06 Emotional (behavioural or psychological)
07 Multiple
09 Disabled but unspecified
Gender: Male Female
Citizen Status: South Africa Dual (SA Plus Other)
Other (Specify)______
Physical address
Postal address
Province :
Gauteng Mpumalanga Free State
Western Cape North West Northern Cape
Kwa-Zulu Natal Limpopo Eastern Cape
Municipality : City:
Learner Residential Area : Urban Rural
Tel number / Fax number:
Cell number
Email address
Highest level qualification completed :
(Highest level school qualification completed e.g. grade 10 ,11,12):
Section B :Particulars Of Next Of Kin
Surname: First name: Title:
Relationship: Tel number: Cell number:
Address:
Section C :Particulars Of Study
Institution Name: Campus:
Student Number: Name of Qualification:
Qualification ID number: NQF level:
Specialisation: Year of studies (e.g. 1st year,2nd year):
Start Date: End Date:
Bursary Amount (Subject to Bursary Conditions) R
Name of Institution
Private  / Public  FET  / HET 
Physical address
Tel number / Fax number:
Email address

Learner Declaration

(Please note that the guardian signature is required if the learner is under 18 years)
  1. I declare to the best of my knowledge that all information on this form is true and correct and I understand that if it is not, I may be eliminated from consideration in the selection process. If after being granted a bursary, any falsehoods or omissions are discovered in my application, I understand that my bursary grant may be terminated.
  2. I undertake to avail myself for participation in all structured learning, practical workplace experience and assessment activities required by the bursary scheme.
  3. I indemnify the LGSETA and its officials against any claim for illness or accidental injury sustained by me in the workplace and during operations in the attainment of the bursary scheme objectives.
  4. I Authorisation the LGSETA to deal directly with the Institute on my behalf and receive copies of my progress reports quarterly and results.

Name and Surname of learner
Signature of learner : Date:
(Only applicable if the learner is a minor)
Name and Surname of parent or guardian
Parent of guardian’s signature: Date:

NOTES AND INSTRUCTIONS FOR COMPLETION

Read these notes carefully before completing the application form. Make sure that you read every section and that the information you provide is accurate.

  1. INCOMPLETE FORMS WILL NOT BE ACCEPTED (this includes forms with missing documents)
  2. The LGSETA does not take responsibility and will not be held liable for any forms which were undelivered or missing.
  3. Student who are granted a bursary from another organisation/institution are obliged to inform the LGSETA. The LGSETA have the right to withdraw funding awarded if the student receives a bursary elsewhere.
  4. The LGSETA bursary is annual award, therefore students will be required to re-apply annually to LGSETA.
  5. Non South African students will not be considered.
  6. The LGSETA will only fund a course which falls within the scarce and critical skills areas in Local Government see Table 1 and 2 below:

Table 1:

OFO Code / LGSETA Scarce and Critical Skills
Occupation
121101 / Chief Financial Officer
121104 / Internal Audit Manager
121301 / Policy and Planning Manager
121905 / Project Manager
132301 / Construction Project Manager
213306 / Water Quality Technician
214201 / Civil Engineer
214202 / Civil Engineering Technologist
216401 / Urban and Regional Planner
241101 / Accountant (General)
242207 / Compliance Officer (Risk Officer)
242211 / Internal Auditor
311201 / Civil Engineering Technician
311203 / Town Planning Technician
313201 / Water Plant Operator
312301 / Building Construction Supervisor
325802 / Paramedic
331301 / Finance Clerk/Administrator
341110 / Legal Advisor/Officer
341201 / Community Development Worker
351302 / GIS Specialist
541101 / Fire Fighter
642601 / Plumber (General)
671101 / Electrician (General)

Table 2

According to Chapter 14 – Schedule 4B of the South African Constitution, the general provisions of local government are as follows:
1 / Air pollution
2 / Building regulations
3 / Child care facilities
4 / Electricity and gas reticulation
5 / Firefighting services
6 / Local tourism
7 / Municipal airports
8 / Municipal planning
9 / Municipal health services
10 / Municipal public transport
11 / Municipal public works only in respect of the needs of municipalities in the discharge of their responsibilities to administer functions specifically assigned to them under this Constitutional or any other law
12 / Pontoons, ferries, jetties, piers and harbours, excluding the regulation of international and national shipping and matters related thereto
13 / Storm water management systems in built-up areas
14 / Trading regulations
15 / Water and sanitation services limited to potable water supply systems and domestic waste-water and sewage disposal systems

Completed application forms with the attachments should be submitted to:

LGSETA, 47 Van Buuren Road, Bedfordview, 2007 or emailed to .

All submissions MUST be clearly marked for the attention of LGSETA Bursaries.

Closing date for applications is 31 May 2016