Please Read These Guidelines Carefully, All Applications Must Be Fully Completed

STUDENT ASSISTANCE FUND SESSION 2013/14

Please read these guidelines carefully, all applications must be fully completed.

Due to the volume of applications to the Student Assistance Fund there will now be a new process of application.

There are two opportunities to apply to the Student Assistance Fund:

Closing Date for Semester 1:Friday 18th October 2013

Closing Date for Semester 2:Friday 14th March 2014.

You are required to submit original receipts/invoices for the full amount sought ie: rent book, lease agreement, receipts for books/materials or travel receipts etc.

If you are in receipt of a SUSI, Back to Education or other income you must attach evidence of this for example a letter from Susi, Department of Social Protection or wage slip.

Please return your appliation form to Finola Mc Ternan, Access Officer, Administration Building.

I wish to apply for assistance for the following (please identify the specific purpose/service for which assistance is requested. Under this scheme, receipts must be provided and these, or copies, will be retained for eventual ESF audit

Supporting statement (attach extra sheet if necessary):

Student’s Income (original supporting documentation must be provided)

YesNoMonth

Student’s Tuition Fees Arrangement in 2013/14:

Have you been allocated Student Assistance Funding in a previous academic year?

If Yes, please tick the previous academic year(s) in which an allocation was made

Are you in receipt of any bursaries, scholarships or grants, other

than the maintenance grant in the 2013-14 session?Yes / No

If Yes, please indicate [tick box(es) as required]

Have you engaged in part-time work in 2013-14 session?

Are you a participant on any support programme operated by NCAD?

Yes / No

If Yes, please indicate

Do you have dependent children?Yes / No

If Yes, please indicate the number

Indicate the number of dependent children in full-time further or higher education

Are you of independent means (i.e. no support from parent(s) /guardian(s))

Yes / No

If No, is one or both of your parents or guardians in receipt of a social welfare payment?

Yes / No

Indicate living arrangements in the 2013-14 session

How did the applicant first become aware of the Student Assistance Fund?

I, Signature of Student______

Confirm that all of the information that I have provided here is true, complete and accurate and that assistance from other sources has not been received for the stated purpose/service that is the subject of this application.

Date of Application to Fund:______

For office use only:

Decision on SAF applicant

If approved for SAF, date of first payment--/--/----

Signed:______

STUDENT ASSISTANCE FUND 2013/14

The following details are required for statistical purposes by the Student Support Unit, Dept. of Education & Science.

PLEASE COMPLETE THE FORM BELOW BY TICKING THE RELEVANT BOXES:

Male

Female

Age

17 – 24

25 – 64

PRIOR TO STARTING NCAD COURSE WERE YOU…?

Please tick as appropriate

In Full Time Education

Long-term unemployed (more than 12 months)

Unemployed (less than 12 months)

Employed

Not available for employment (more than 12 months)

Not available for employment (less than 12 months)

PRIOR TO STARTING NCAD COURSE HAD YOU….?

Please tick as appropriate

No qualification

Primary/lower secondary education

Upper secondary education

Post-secondary non-tertiary education

Tertiary education (below Level 10)

.

All information provided is private and confidential.

This data is requested by the National Access Office, as part of the reporting requirements of the European Social Fund co-financed programme.