APPLICATION)FOR)2016)SRC)TRUST)FUND)

)
CLOSING)DATE:)20)JANUARY)2016)
)

Kindly)send)the)following)documents)along)with)the)application)form)to)
trustfund@uj.ac.za)
!
o!If!both!parents!are!working,!recent)payslips)not!older!than!2!months!are!required!from!each!
parent.!If!a!parent!is!paid!on!a!weekly!basis!four!consecutive!payslips!should!be!submitted.!If!a!parent!
is!paid!on!a!two=weekly!basis!(fortnightly)!2!consecutive!payslips!should!be!submitted.!!
o!If!a!parent!is!unemployed!an!affidavit)signed)by)the)unemployed)parent)is!required,!confirming!
his/her!own!unemployment.!!
o!If!a!parent!is!working!in!the!informal!sector!where!official!payslips!are!not!issued!(eg!street!
vending!or!informal!selling)!the!rand!value!of!the!income!gained!per!month!must!be!stated!in!the!
affidavit.)!
o!If!a!parent!is!employed!as!a!domestic!worker,!a!letter)from!his/her!employer!is!required,!stating!
the!period!of!employment!and!the!monthly!salary.!!
o!If!there!is!anybody!in!the!household!that!receives!a!state!pension!or!a!child!support!grant,!proof!is!
needed.!A!certified!copy!of!the!most!recent!pension!slip,!pay!point!slip!or!an!original!3!month!bank!
statement!should!be!submitted.!!
o!If!the!family/student!is!sponsored!an!affidavit!signed!by!the!sponsor!should!be!submitted!stated!
the!monthly!rand!value!of!the!sponsorship.!!
o!If!parents!are!divorced!a!certified!copy!of!the!divorce!decree!should!be!submitted.!!
o!If!a!parent!is!deceased,!a!certified!copy!of!the!death!certificate!should!be!submitted.!!
o!If!the!whereabouts!of!a!parent!is!unknown!or!if!the!parent!has!absconded!or!does!not!contribute!
towards!the!finances!of!the!family,!an!affidavit!is!required!from!the!parent!whom!the!student!lives!
with.!The!parent!writing!the!affidavit!should!not!only!indicate!that!he/she!is!single,!but!also!that!the!
other!parents!whereabouts!are!unknown!and!that!no!financial!support!is!received.!!
o!If!a!student!lives!with!his/her!grandparents,!or!guardian!an!affidavit!from!the!guardian!or!
grandparents!is!required,!stating!the!whereabouts!of!the!biological!parents!and!the!rand!value!of!the!
parents!monthly!support!to!the!student.!If!R0!it!should!be!stated.!Proof!of!income!of!grandparents!
should!then!also!be!provided.!!
o!If!a!sibling!(brother!or!sister)!over!the!age!of!18)is!unemployed!and!is!still)living)with)the)family)
an!affidavit)signed)by)the)unemployed)sibling)is!required,!confirming!his/her!own!unemployment.!
If!the!sibling!is!employed,!recent!payslips!(not!older!than!2!months)!is!required.!!
o!If!a!sibling!is!studying!a!tertiary!institution!(university)!a!proof!of!registration!of!that!particular!
student!is!required.!!
o!Certified!copies!of!identity!documents!(or!birth!certificates!where!identity!documents!are!not!
available)!for!the!every!member!of!the!household!including!the!applicant!should!be!submitted.!!
o!If!a!students!surname!differs!from!his/her!parent!surname,!an!affidavit!from!one!of!the!parents!
must!be!submitted!as!to!why!the!surnames!differ.!!
o!All!copies!of!documents!must!be!certified!!
o!Please!make!sure!all!required!documentation!is!attached!before!submitting!the!application!form,!as!
incomplete!applications!will!not!be!processed!and!it!will!be!regarded!as!an!unsuccessful)application.!!

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SECTION!1:!PERSONAL!DETAILS!
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Surname!
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First!Name! !!!
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Title! !
!!Mr!!! !!!!!!!!!!!Mrs!!!
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Date!of!Birth! !!!
(DD/MM/YY)!
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Student!Number!!
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Home! !
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Address!
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Cell!phone!!
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Residential!
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Address!!
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Contact!no.!
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Fax!
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Email! !
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!!!!!!!Miss!!

!!!!!Ms!!

!!!!!!!!Other!!

SECTION 2: COURSE DETAILS

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Course!/Programme! !
Of!Study!
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Course!/Programme! !
Title!
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Is!your!course/!!Full=time!!
Part=time!!
Evening!!
Other!!
Programme!
! SECTION 3: WHERE YOU LIVE
Year!of!Study!!1st!
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2nd!
3rd!
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4th! !
Post!grad!!
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(give details)
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Do!you!live:!On!your!own!!
With!parent(s)!!
Residence!!
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Other!!
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SECTION!4:!AGREEMENT!
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4.1!ATTENDANCE)AT)THE)INSTITUTION!
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4.1.1! The!Student!hereby!agrees!and!undertakes!to!attend!diligently!and!
continuously,!all!such!classes!during!the!academic!year!as!prescribed!by!the!
Institution.!
!
4.1.2! The!Student!shall!write!all!such!assessments,!and!receive!such!other!form!
of!instruction!as!may!be!laid!down!in!the!course!prescribed!by!the!
Institution,!and!shall!abide!by!the!rules!and!regulations!of!the!Institution.!
!
4.1.3! The!Student!hereby!authorises!SRC!Trust!Fund!at!any!time,!and!from!time!
to!time,!to!request!and!obtain!any!academic!or!financial!information!
about!the!Student!which!Trust!Fund!may!require,!whether!from!the!
Institution!or!from!any!employer,!bank!or!other!financial!institution,!or!
from!any!other!person,!without!the!prior!consent!of!the!Student.!
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4.2!VALUE)OF)FINANCIAL)ASSISTANCE!
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4.2.1! The!financial!assistance!offered!by!the!Trust!Fund!to!the!student!will!be!as!
follows:!
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4.2.2! The)minimum)payment)for)registration)(R3870.00))at)the)time)when)
the)application)was)approved)
)
4.2.3! Bursary! will! be! allocated! only! for! formal! courses.! No) bursaries) will) be)
awarded)for)certificate,)non[)formal)diploma,)bridging,)non[degree)and)
non[subsidised)courses.)
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4.2.4! All!monies!payable!in!respect!of!registration!fees,!shall!be!paid!to!the!university!
and! any! balance! which! is! not! used! for! this! purpose! is! to! be! refunded! to! the!
Trust!Fund.!
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4.2.5! !!!!No!reimbursement!shall!be!made!to!a!student.!
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4.2.6! The! SRC! Trust! fund! assistance! will! only! cover! the! minimum! registration!!!!
payment,!therefore!students!are!still!liable!to!pay!outstanding!fees.!Please!refer!to!fee!
booklet!for!payment!deadlines.!
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4.3!BREACH)BY)STUDENT)
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If!the!Student;!
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4.3.1! absents!him/herself!without!good!cause!from!attending!the!class;!or!
4.3.2! refuses!or!without!good!cause,!fails!to!complete!the!course;!or!
4.3.3! is!expelled,!suspended!from,!or!required!for!any!reason!to!vacate!the!Institution!
on!account!of!misconduct!on!his/her!part;!or!
4.3.4! fails!to!comply!with!or!fulfill!any!of!his/her!obligations!as!set!out!in!this!
agreement;!or!
4.3.5! is!convicted!of!a!criminal!offence;!or!
4.3.6! produces!any!references!or!certificates!which!are!later!ascertained!to!be!
fraudulent;!
!
Then!this!agreement!may!be!terminated!immediately!by!the!SRC!Trust)Fund)
without!prejudice!to!any!of!its!rights!set!out!herein!or!at!law.!
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4.3.7! If!this!agreement!is!terminated!for!any!of!the!reasons!set!out!above!!the!
Student!shall!repay!to!the!Trust!Fund)or!the!University!all!fees!as!have!been!
paid!or!which!have!become!due!and!payable!by!the!SRC!Trust)Fund!at!the!
prime!overdraft!at!the!time!of!termination!of!the!contract.!
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4.3.8! If!the!students!cancel!their!studies!before!writing!the!June!examinations,!the!
financial!assistance!will!be!cancelled.!
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4.3.9! Notwithstanding!the!provisions!of!Clause!4.3.,!the!SRC!TRUST)FUND!may,!in!its!
sole!discretion,!permit!the!Student!to!continue!with!the!course!provided!that!
the!Student!shall!in!such!circumstances,!unless!otherwise!decided!by!the!SRC!
Trust)Fund,)repay!to!the!Fund!all!tuition!and!residence!fees!payable!by!the!
Fund!for!the!period!of!the!student's!default.!
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4.4!UNDERTAKING!
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I!hereby!accept!all!the!terms!and!conditions!set!out!herein!which!are!applicable!to!
me!and!agrees!at!all!times!to!be!bound!by!the!terms!and!conditions!hereof.!
Furthermore,!I!fully!understand!that!this!is!just!an!application!and!does!not!
guarantee!that!I!will!be!assisted!financially.!
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STUDENT/APPLICANTS!SIGNATURE! !
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DATE!