Spiers Trust Application Form
- Reference should be made to the Notes for Guidance
- All sections of the form should be completed, where appropriate.
Section 1: Personal Details of Applicant
Name (include title):
Home Address including post code:
Term Address including post code:
Telephone Number:
Mobile Number:
Email Address:
Date of Birth: / Marital Status:
Section 2: Previous Education
School last attended:
Date of leaving school:
Certificates obtained:
University or Colleges attended since leaving school, stating dates of attendance:
Section 3: Purpose of Application
Name of Course:
Details of proposed course/tuition etc to be undertaken:
Name of University/College/ Establishment offering course/ tuition:
Address of University/College/ Establishment offering course/ tuition:
Duration of course:
Which year of this course are you going into?
Please specify whether course is full-time/part-time/day release/ evening:
Qualification to be obtained:
Purpose of obtaining qualification:
Amount of grant requested: / £
Cost of the course for the year (Scottish students studying in Scotland do not ordinarily pay towards the fees of their course). Please indicate a breakdown of the relevant course costs, other than fees:
Course fees (if not paid by the Scottish Government: / £
Books, Course Materials: / £
Equipment / £
Uniform: / £
Travel: / £
Other (please specify): / £
Estimated Total Cost: / £
Section 4: Financial Circumstances
An applicant is regarded as being dependent upon his/her parents if he/she is in full-time education until the age of 25. An applicant is considered to be independent if he/she has reached the age of 25 or he/she has been self-supporting for any period of three years beforehand and/or marries/cohabits before their course begins.
In determining the amount of grant to be awarded to the applicant, the Committee shall have regard to the Applicant’s parents’ financial circumstances, where the applicant is dependent and the applicant’s financial circumstances where the applicant is independent. The applicant and where appropriate, the parents/spouse/partner of the applicant agree that the provision of the following information is necessary and commit to providing complete and accurate information. The following details will be treated in the strictest confidence and will be held and processed in accordance with the Data Protection Act 1998.
(a) / To be completed by all Applicants:
Funding from other sources, e.g. Education Maintenance Allowance, Young Student Bursary, Student Loan, Scholarships, Temporary/part-time work:
(b) / To be completed if Applicant is dependent:
Name of Parent (1)
Address including post code:
Employer:
Occupation:
Gross income:
Name of Parent (2)
Address including post code:
Employer:
Occupation:
Gross income:
(c) / To be completed if Applicant is independent.
Name of Employer:
Occupation of Applicant:
Gross Income:
(d) / To be completed if Applicant is married/cohabits and spouse/partner is in employment:
Name of Spouse/Partner:
Address including post code:
Employer:
Occupation:
Gross Income:
(e) / Other relevant information:
Have you ever received financial assistance from the Spier’s Trust? / No Yes
If yes, please give details: / Date(s):
Amount(s):
Purpose:
If independent, do you have any dependent children? / No Yes
If yes, please give details:
If dependent, do your parents have any other dependent children? / No Yes
If yes, please give details:
Other relevant information which you think may be of interest in support of your application:
Declaration: (to be signed by the Applicant and also by the parents/spouse/partner if appropriate).
I declare that I have accurately and fully answered the questions set out above. I understand that the information I have supplied is necessary to enable the Committee to consider my application and I agree to supply any more information that the Committee may require. I understand that if I am awarded a Spier Grant, I may be required to repay all or part of it should I not complete the course/tuition in respect of which it was awarded. I understand that North Ayrshire Council (“the Council”) acts on behalf of the Spier’s Trust.
Data Protection: North Ayrshire Council gathers and process information about you so that services, including this form, can be delivered effectively and efficiently. We will only ask for the minimum information necessary and process this in line with the provisions of the Data Protection Act (1998). A copy of our privacy Policy Statement is available on request or can be viewed on our website at
By ticking this box you are agreeing to your information being gathered and processed as above:
Applicant Name: (please print)Signature of Applicant:
Signature of Parent/Spouse/Partner:
Date:
We will keep your information on file for up to 3 years. If you wish this information to be removed please contact us and we will remove within 30 days.
Please return to:
Bernadette Anderson, Performance/Grants Information Officer,
Connected Communities, Economy and Communities
Focus Community Learning Centre, Primrose Place, Saltcoats, KA21 6LH
Telephone: 01294 608041; Email:
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