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Annexure A22022BURSARY APPLICATION FORM-Undergraduate studiesInstructions to applicants Closing date: 31 October 2021Use block letters to complete the formGive concise answers and, where applicable, mark with an X.This form may only be used by persons who are not staff members of the departmentAttach a recent copy of your ID, academic record and copies of qualification/certificatesIncomplete or late applications will not be consideredForward application to ONLY ONE of the following addresses:The DirectorAgriculture Place20 Steve Biko (Former Beatrix) StreetSector Education and TrainingArcadia, PretoriaDepartment of Agriculture, Land Reform and Rural Development0002Private Bag X250PRETORIA0001Email address: Externalbursaries@dalrrd.gov.zaA. Particulars of applicantTitle: .Surname: .First names: .MaleFamaleIdentity NumberAfricanColouredIndianWhiteNationality: .Province: .Municipality: Area: .DisabilityYesNoIf YES, state nature of disability: .Marital status: .Home language: .
Postal addressResidential address. .Postal codePostal codeE-mail: .Cellphone:. . .Tel no. (h): .Code: .Tel no. (w):.Code: .Fax no.:.Code: .B. High school information (Compulsory for all applicants)Name of the school: . .Type of schoolPublicPrivateIf PUBLIC, Indicate quantile ratingHighest grade passedGrade 1112345Grade 12Subjects (list them)Marks/%Level/Symbol . . . . . . . . . . . . . . . .SCHOOL STAMP.Principal’s signatureNB: Principal’s signature and school stamp is only applicable to current grade 12 learners
C. Particulars of degree/diploma for which you wish to receive the bursaryAt which university or institution are you/do you intend studying? .Fields of studyCross ONLY one field of study [X]B.Sc. Bioresource Engineering (Agricultural Engineering)Bachelor of Veterinary Science (B.V.Sc.)B.Sc. Animal ScienceB.Sc. EntomologyB.Sc. Food ScienceB.Sc. Pasture ScienceB.Sc. Plant PathologyB.Sc. Viticulture and OenologyB.Sc. Land Surveying/GeomaticsB.Sc. Town/Urban and Regional PlanningB.Sc./BA Geo-Informatics/Geographic Information ScienceNational Diploma: Food TechnologyNational Diploma/B Degree: Surveying/CartographyNational Diploma/BBE: Town and Regional PlanningMotivation for the chosen study field .Mark the academic year of study for which you are applying123456D. Other bursaries/study loansAre you at present studying with a bursary or study loan?YesNoIf yes, name of the bursary/study loan: .Annual value of the bursary/study loan: .E. Income statusFather’s occupation: .Mother’s occupation: .Guardian’s occupation: .Mark your combined parents or guardians income (R) 10 00010 001–30 00030 001 and aboveAttach proof ofincome for bothparents or proof ofincome from SASSA
F. Details of parents/guardian/next of kinTitle: .Surname: Initials: Full name: .Identity NumberRelationshipMotherFather Other, specify .Postal addressResidential address . . . . . .Postal codePostal codeE-mail: .Cellphone no: .Tel no. (h): .Code: .Tel no. (w): .Code: .Fax no.: .Code: .G. DocumentationPlease attach certified copies of the following Identity document (Applicant)Identity document (Parents/Guardian)Death certificates (If applicable)Certified copies of qualificationsAcademic Record/Grade 12 Results and Universityacceptance letter Family income (Salary advice not older than 3months)SASSA confirmation letter (If applicable)Proof of unemployment obtainable fromthe Department of Labour (If applicable)H. DeclarationI certify that the information supplied in this application is correct and that, if I am awarded a bursary, I willabide by the regulations applicable.Signature: .Date: .If still a minor, signature of parents/guardian .Date:. . .
CHECKLISTTo be completed by Applicant(Mark with an X)YesNoIdentity document (Applicant)Identity document (Parents/Guardian)Death certificates (If applicable)Academic Record/Grade 12 Results and University acceptance letterSASSA confirmation letter (If applicable)Proof of income (Salary advice not older than 3 months)Proof of unemployment obtainable from the Department of Labour (If applicable)Important notes for applicants Applicants who are not in possession of their University acceptance letter or final results can submittheir application while waiting for the said documents.No faxed application forms will be consideredNo late applications will be considered
BURSARY APPLICATION FORM-Undergraduate studies-Annexure A2 202. 2. Instructions to applicants Closing date: 3. 1 October. 202. 1 Use block letters to complete the form Give concise answers and, where applicable, mark with an . X. This form may only be used by persons who are not staff members of the department
