BURSARY APPLICATION FORM

ALL APPLICANTS FOR FINANCIAL ASSISTANCE MUST COMPLETE THIS FORM IN ITS ENTIRETY.
UNANSWERED PORTIONS AND/OR ABSENCE OF PROPER SIGNATURES WILL CONSTITUTE AN
INCOMPLETE APPLICATION AND WILL DISQUALIFY THE APPLICANT FROM CONSIDERATION.
INFORMATION WILL BE HELD IN STRICT CONFIDENCE.

APPLICANT’S INFORMATION

FIRST NAME(S) _________________________________________________ LAST NAME: _________________________________________________

1. a) 2007/8 Gross Income (Sept – Aug) £ _______________________ 6. a) What Liabilities do you have to:
Nature of Job(s) ______________________________________________ i. Local Education Authority: £
Estimated Gross Income from January until August 2009 £ ______ ii. The Student Loans Company: £
iii. College or University: £
IF APPLICABLE: iv. Bank: £
b) Spouse / Partner: v. Credit Card: £
2007/8 Gross Income (Sept – Aug) £ ___________________________ vi. Other (please specify):£
Nature of Job(s) ______________________________________________
Estimated Gross Income from January until August 2009 £ ______ b) What Assets do you have?
i. Cash: £
2. Did you pay income tax for 2007/8? (estimate)
Amount £ _____________________ ii. Other – please list:£

3. Financial Assistance already secured for the coming summer: _______________________________________________________________

Cash in Hand £ ___________ Assistance from family £ ____________
Other assistance for Summer 2009 (e.g. scholarships, grants, loans & _______________________________________________________________
gifts etc. awarded and pending.) Please state source and amount.
______________________________________________________________
FINANCIAL INDEPENDENCE
______________________________________________________________
1. Are you over 21 years of age? Yes / No
______________________________________________________________ 2. Are you a post-graduate student? Yes / No
3. Are you supporting any dependents (i.e. children, elderly parent)?
4. Are you the recipient of any educational funds (scholarship, grant Yes / No
award, or prize) from a country, organisation or individual If you have answered ‘Yes’ to one or more of the above questions, you
may claim yourself financially independent.
specifically for your attendance at Lake District Summer Music during
If you have answered ‘No’ to the above questions answer questions 4 & 5.
2009? Yes / No
If ‘Yes’ please give details (including those pending). Please state 4. Did you live in your parents’ home for six consecutive weeks in the
source and amount. _________________________________________ past year? Yes/ No

______________________________________________________________
______________________________________________________________
5. How much aid would you need to come to Lake District Summer
Music? Please be aware we may not award the full amount you ask
for. £______________________________
5. Have you received more than £2,000 assistance from your parents
in the past year? (Including clothing, medical care, insurance etc.)
Yes / No
If you have answered ‘No’ to both questions 4 & 5, above, then you may
claim yourself financially independent.
If you have answered ‘Yes’ to one or more of the above questions, you
must ask your parents to submit the required financial data below.

PLEASE PROVIDE AN INDEPENDENT FINANCIAL REFEREE

NAME:_____________________________________________________ ADDRESS:__________________________________________________________________

__________________________________________________________________________________________________________________________________________

CONTACT TELEPHONE NUMBER:____________________________________________ EMAIL:_________________________________________________________

RELATIONSHIP OF INDIVIDUAL TO YOU:_____________________________________________________________________________________________________

IF NOT FINANCIALLY INDEPENDENT PLEASE ASK YOUR PARENTS/GUARDIAN TO COMPLETE THE FOLLOWING:
2007/2008 Fiscal Year Gross Income Other Information
Father / Guardian EMPLOYER:
POSITION:
CONTACT TELEPHONE No:
Mother / Guardian EMPLOYER:
POSITION:
CONTACT TELEPHONE No:

Father/Guardian’s signature: _____________________________________________________ Date:___________________

Mother/Guardian’s signature:____________________________________________________ Date:___________________

ALL STUDENTS MUST SIGN THIS DOCUMENT:

APPLICANT’S SIGNATURE: ________________________________________________________ Date:___________________

I understand that this application cannot be considered until the application form, deposit, passport-size photograph, CV
and additional information have been submitted.
Additional Information may be attached on a separate sheet which must be stapled to this form