Case Ref (office use):
OU Students Educational Trust Application for
Charitable Funding
[Offender Learners]
CONFIDENTIAL
Case number of most recent previous application to OUSET, if any:
Please use this form if you are an Open University categorised as an Offender Learner and
interested in making an application to the OU Students Educational Trust.
Please read the OUSET Eligibility Criteria and the Guidance Notes before completing the form.
If you have any questions regarding this form or if you require additional information about the
application process or to submit your completed application please contact ouset@open.ac.uk, call
01908 652026 or write to OUSET, PO Box 397, Walton Hall, Milton Keynes, MK7 6BE.
1. PERSONAL DETAILS
Surname
First Name(s)
OU Personal Identifier
Prisoner Number
Prison Address & Postcode
Name of Contact within the
Education Department (if
applicable/ known)
Phone number of Education
Department Contact
Email Address of Education
Department Contact
Page 1 of 4- Offender Learner OUSET Application
Open University Students Educational Trust. Registered Charity number 285189/SCO38300. OUSET is owned and
administered by the OU Students Association.
Case Ref (office use):
2. STUDY DETAILS
Details of the module(s) this application relates to:
Module Code
Module Title
No. of Points
Start Date
End Date
Details of the qualification you are working towards:
Qualification Code
Qualification Title
Completed Points
Please give details of any completed academic qualifications. If you are applying for assistance with
postgraduate study, this must include your most recent undergraduate degree:
Qualification Obtained
Date
Awarding Institution
3. DETAILS OF REQUEST FOR FINANCIAL ASSISTANCE
Please specify the assistance you are applying for:
Category of Grant Request
Details
Cost (£)
A) Module fees
B) Other financial
assistance (e.g. set
books, equipment)
Page 2 of 4- Offender Learner OUSET Application
Open University Students Educational Trust. Registered Charity number 285189/SCO38300. OUSET is owned and
administered by the OU Students Association.
Case Ref (office use):
Please give details of any other applications you have made for financial
assistance with this study, including applications to the Student Loans Company and the OU’s
Study Support Fund. PLEASE NOTE you may be eligible for a student loan if you have less
than six years left on your sentence and meet other criteria. Please ask your Education
Department to investigate BEFORE making an application to OUSET.
Source of funding applied for
Amount requested
Amount obtained/ Reason not
obtained
4. STATEMENT IN SUPPORT OF APPLICATION
It will help the Trustees considering your application if you can give us more information or details of
special circumstances that have led you to apply to OUSET for financial assistance. Please
complete on a separate sheet if necessary.
Page 3 of 4- Offender Learner OUSET Application
Open University Students Educational Trust. Registered Charity number 285189/SCO38300. OUSET is owned and
administered by the OU Students Association.
Case Ref (office use):
5. FINANCIAL DISCLOSURE
Your application will not be considered without the following supporting evidence. Please tick to
confirm you have included the following:
Three months consecutive prison account statements
If it is relevant to your application and if you are
registered with the Open University as a
disabled student, please state the nature of the
disability.
Please detail any savings you have, or indicate
NONE:
Name of bank/ building society:
Amount of savings:
6. DECLARATION
This application will not be considered without a Letter of Support from your Education Department
or learning supervisor. We will contact the Prison and/or Open University on your behalf to obtain
this. In addition we may contact other agencies in connection with your application. Do you
authorise OUSET to consult with the Prison Service, The Open University and the Prisoner
Education Trust on matters relevant to this application?
Yes
No
I declare that to the best of my knowledge all the information entered on this form is correct and
complete and reflects a true picture of my financial position.
Signature of Applicant:
Name of Applicant:
Date:
Please note that submission by email will be regarded as a signature.
You can return your completed application to the OUSET team at the OU Students Association
office by email to ouset@open.ac.uk or by post to the OU Students Educational Trust, PO Box 397,
Walton Hall, Milton Keynes, MK7 6BE.
Applications will not usually be considered unless made within the specified application window,
details can be found at http://www.open.ac.uk/ousa/help-and-support/ouset or obtained from the
office. We will confirm receipt and it will usually take between 4 and 6 weeks to receive a decision
from the Trustees. If you have any questions about completing this application please contact the
OUSET team by email or on 01908 652026.
Page 4 of 4- Offender Learner OUSET Application
Open University Students Educational Trust. Registered Charity number 285189/SCO38300. OUSET is owned and
administered by the OU Students Association.