APPLICATION TO THE
FINANCIAL SUPPORT FUND 2015/16
FROM PLYMOUTH UNIVERSITY
Welcome to the Plymouth University Financial Support Fund application. Please ensure that you read
the following information, as well as the full guidance notes which are available here:
https://www.plymouth.ac.uk/study/fees/scholarships-bursaries-and-funding/bursaries before you
start completing this form. This will help you to understand more about the fund, how to complete your
application, and will give you an idea whether you are likely to qualify for help from us.
The University will only normally consider one Financial Support Fund application in each academic year
and the opening period for the 2015-16 year will be from 1st October 2015 to 3rd June 2016. Please
note that FINAL YEAR students must submit their completed and fully documented applications by
13th May 2016 otherwise we will be unable to consider your request for a Standard Award.
Only applications received with full and complete documentation within the opening period will be
accepted. If full evidence is not provided by the deadline, your application will be closed and no
assessment will be undertaken.
The support available is intended to help students who have higher than average costs due to either
having a disability, dependent children/adults, exceptional circumstances or for those who are
vulnerable and are facing financial hardship.
The Financial Support Fund should not be depended upon as a sole source of income, and will not
necessarily cover a shortfall in funding. Awards are only ever intended to be a contribution towards
costs, and will therefore not necessarily cover all your additional financial needs.
All applications are assessed using information that is unique to you, and this means that the outcome
of your application or the level of assistance awarded cannot be compared to that of any other student
or discussed by us. Please be aware that submitting an application for support does not in itself
guarantee an award.
Amounts awarded are subject to rigorous assessment, availability of funds and volume of applications;
please be aware that this can influence the amount you receive and you will not necessarily receive the
same level of award as in any previous applications.
We aim to assess your application within 28 days of receipt, on the condition that all required
documentation is supplied at submission, and will contact you once completed.
Payments will be made into your designated bank account and your award letter will be emailed to you,
detailing the outcome and any payment date.
All correspondence will be sent to your University email address and it is your responsibility to keep us
updated if you are awaiting evidence to be sent to you by a third party.
Please note that in completing this application, you are applying for a STANDARD AWARD from the
Plymouth University Financial Support Fund.
NON STANDARD (EMERGENCY) AWARDS, are only considered in exceptional and unforeseen
circumstances, NOT simply because you have run out of money.
If you feel that this is the case, and that you need to apply for a NON STANDARD AWARD, please contact
studentfunding@plymouth.ac.uk to briefly outline the reason for your request and to obtain an
application form.
Please return the fully completed form and evidence to: The Student Funding Unit, 4th Floor Nancy Astor
Building, Plymouth University, Drake Circus, Plymouth PL4 8AA.
PLEASE BEGIN YOUR APPLICATION HERE
1. PERSONAL DETAILS - FOR ALL APPLICANTS TO COMPLETE
Student number
Your title
o Mr
o Mrs
o Miss
o Ms
Other – please state
Your first name (in full)
Your family name (in full)
Contact telephone number
Term-time address
including postcode
University email address
Date of Birth (dd/mm/yyyy)
Your age on 01/09/15
Nationality
Residency status
years
o Home (UK) Fee
o Overseas Fee
Tell us about where you live,
is this:
o Alone
o With your spouse or partner
o In shared accommodation
o With your parents or guardian
Do you share all household
o Yes
expenses?
o No
Do you maintain 2 homes?
o Yes
o No
If you have answered ‘YES’, please can you tell us a bit
more about this.
2. ELIGIBILITY - FOR ALL APPLICANTS TO COMPLETE
Please tell us if any of these
apply to you?
Please tell us which of these
apply to you?
Have you applied for your
full entitlement
of your statutory support
package from SFE?
I am a postgraduate student (excluding PGCE)
I am an International student
I am a European student
I am a full time UK (Home) student
I am a part-time UK (Home) student
I am a PGCE student
YES
NO
N/A – I am not eligible for Student Finance
If you are not eligible for Student Finance,
please can you briefly explain why
o
o
o
o
o
o
o
o
o
Have you received the first
o YES
instalment of your statutory
o NO
support i.e Loan, Grant,
o N/A
NHS bursary
Are you applying for
o YES
financial help because your
o NO
statutory support has been If you have answered ‘YES’, please DO NOT CONTINUE
delayed? with this form. You should instead contact the Student
Funding Unit to request a Short Term Loan. You can
retain this form and submit an application when you
have had the first instalment of your student funding.
3. COURSE DETAILS - FOR ALL APPLICANTS TO COMPLETE
What is the title of your course
Faculty/ Department
Are you studying
o Full time
o Part time
When did you start your course? (dd/mm/yyyy)
Part timers only- How many
credits are you taking this year?
What year are you studying?
Is this your final year?
o YES
o NO
Is this a repeat year?
o YES
o NO
Have you been on a previous HE
o YES
course?
o NO
If ‘YES’, do you already hold an
o YES
honours degree?
o NO
If ‘YES’, please provide evidence of your Honours
Degree
Is this a placement year?
o YES
o NO
If ‘YES’, is it a paid placement?
o YES
o NO
4. FOR POSTGRADUATES ONLY (NOT PGCE)
You are expected to have made a realistic financial provision for tuition fees and living
costs for the whole academic year, at the onset of the course.
Please tell us all annual sources of your provision
Earnings
o £
Grant
o £
Sponsorship
o £
Loans
o £
Parental contribution
o £
Postgraduate Scholarship Scheme
o £
Other - please tell us about this
o £
TOTAL EXPECTED FINANCIAL
PROVISION FOR THE YEAR
o £
5. YOUR FAMILY - FOR ALL STUDENTS TO COMPLETE. Please tell us about
the family who you live with or those who live elsewhere that you financially
support.
Do you have a partner?
o YES
o NO
If ‘YES’, is your partner
o YES
dependent on you?
o NO
Do you have any children
o YES
living with you who are
o NO
financially dependent on If ‘YES’, please can you list their details below, and provide
you? documents to support this.
NAME
RELATIONSHIP TO
AGE
YOU
Do you have any children
o YES
living elsewhere who are
o NO
financially dependent on If ‘YES’, please can you list their details below, and provide
you? documents to support this.
NAME
RELATIONSHIP AGE
TO YOU
6. DISABILITY/MEDICAL CONDITION/LEARNING DIFFICULTY - FOR ALL
STUDENTS TO COMPLETE
Do you have a
o YES
disability, medical
o NO
condition or learning If ‘YES’, please provide some brief information below
difficulty?
Have you applied
o YES
for the Disabled
o NO
Students’ Allowance? If ‘YES’, please can you provide documentary evidence of this.
Do you wish to apply for any financial assistance towards special equipment/materials
which are NOT covered by DSA, or for assistance towards the cost of a diagnostic test
i.e. Dyslexia test? Please note that these tests will not be automatically covered.
o YES
o NO
If ‘YES’, please can you provide details of these below and provide evidence of costs.
WHAT DO YOU REQUIRE?
HOW MUCH WILL THIS COST?
7. DEBTS TO THE UNIVERSITY - FOR ALL STUDENTS TO COMPLETE
Please note that if you qualify for an award, we will automatically pay off any
outstanding Short Term Loans from this academic year – to date of this application.
Do you have an
o YES
outstanding Short
o NO
Term Loan debt for If ‘YES’, please can you tell us how much you still owe?
the current academic £
year?
8. BANK DETAILS/BUILDING SOCIETY ACCOUNTS - FOR ALL STUDENTS TO
COMPLETE
Please provide 3 months recent statements for ALL of yours, and your partner’s (if you
have one) accounts including savings as shown below.
Name of Bank/Building
Current
Agreed
Society/Credit Card
Balance
overdraft limit
9. TRAVEL COSTS - PLEASE COMPLETE only if you incur travel costs that are
not reimbursed and if you DO NOT live in walking distance of the University,
or are unable to do so.
Please provide evidence of your travel costs
During the academic
o Once a week
year, on average I have
o Twice a week
to pay to travel to
o 3 times a
University
week
I travel by
o car
o train
o bus
o 4 times a week
o 5 times a week
o taxi
o another method –
please tell us about this
below
On average my WEEKLY travel £
costs me
If you live in walking distance of the University but are unable to do so, please can you
briefly tell us why this is:
FOR STUDENTS WITH COURSE RELATED PLACEMENT COSTS ONLY
How many weeks a year will you spend
on placement?
How much a year will you spend on £
placement travel costs?
Are your travel costs to placement
O FULLY REIMBURSED
O NOT REIMBURSED AT ALL
O PARTLY REIMBURSED – please tell
us more about this below
10. PAYMENT BY BACS – FOR ALL STUDENTS TO COMPLETE. Please tell us
where you would like your award to be paid, if you qualify.
Your student number
Your full name
Bank/Building society name
Account number
Sort Code number
If you no not want to be paid
by BACS please indicate here
o I request payment by cheque
11. PERSONAL CIRCUMSTANCES - FOR ALL STUDENTS TO COMPLETE
This is your opportunity to give us a broader understanding of your situation, so please ensure that you
include as much relevant information as possible. PLEASE REMEMBER TO SUPPORT YOUR
STATEMENT WITH DOCUMENTARY EVIDENCE.
12. BUDGET PLANNER – FOR ALL STUDENTS TO COMPLETE – it is really
important that you put an entry into every box that requires an amount, so
please put a zero in any that does not apply to you, rather than leaving it
blank or putting N/A.
INCOME –
including partner’s
Maintenance Grant/Special
Support Grant
Maintenance Loan
£
YEARLY
Parents’ Learning Allowance
Adult Dependants’ Grant
Childcare Grant
NHS Social Work Bursary
NHS Bursary
TDA Bursary
University Bursary
PSMD Bursary
Disabled Students’ Allowance
Scholarships
Professional/ Career
Development Loan
Grants/Trusts
Savings
Parental or Partner’s
contribution
Your net earnings – term time
Partner’s net earnings
Child Tax Credit
Working Tax Credit
Child Benefit
Child Maintenance
Housing Benefit
Income Support
Job Seeker’s Allowance
ESA
Disability Benefits – please specify
below
EXPENDITURE –
£
including partner’s MONTHLY
Rent /Mortgage
Rent / Mortgage arrears for
current property
Council Tax
Gas/Electricity
Water
Telephone
Food / Household / Laundry
TV Licence
Buildings insurance
Other insurances( excluding car)
Car costs( excluding petrol)
Accredited childcare costs
Course related travel to University
and back
Cost of returning home during
holidays
Cost of getting to work and back
Placement travel costs that you
DO NOT get back
Tuition fees if you are self-funding
Course costs i.e.
books,equipment
Disability costs not met by DSA
ONGOING prescribed medication
Child Maintenance Support
Priority debts( IVA, DMP etc.)
TOTAL PER MONTH £
PLEASE LIST BELOW ANY ‘ONE OFF’ COSTS
Other income – please specify
below
TOTAL PER YEAR £
TOTAL ONE-OF COSTS £
13. DOCUMENT CHECKLIST –ALL STUDENTS NEED TO COMPLETE. It is your
responsibility to provide documentary evidence of all the information that you have told
us about AT THE SAME TIME THAT YOU SUBMIT THIS APPLICATION. Please be aware
that if you don’t do this, we will cancel your application and return your form to you.
PLEASE TICK THE BOXES TO SHOW THAT YOU HAVE ATTACHED PHOTOCOPIES OF
THESE DOCUMENTS –ORIGINALS WILL NOT BE RETURNED. Ensure that the amounts shown
on your budget planner correspond accurately with the information on your documents.
ALL STUDENTS please provide:
o 3 month’s bank statements for ALL accounts including savings for you and your partner (if
applicable)
o Evidence of accommodation costs – Tenancy agreement or Mortgage statement which must
clearly show your name, address and the monthly payment
Please provide evidence of the following only IF APPLICABLE and already mentioned in this
application:
o Child Tax Credit/Working Tax Credit Award Notice – please ensure this is the most recent
version and that it outlines your current entitlement
o Housing Benefit Award notice– please ensure this is the most recent version
o Social Work Bursary Award Notice
o Other bursaries and Scholarships Award Notice
o 3 month’s payslips – for you and your partner (if applicable)
o Travel evidence – petrol receipts, train or bus tickets covering a typical month’s travel
o Child Maintenance payments - this should be for payments made or received
o Course related childcare costs – please ensure this shows your current costs for 3 months
o Compulsory field trip costs that you have to pay yourself - evidence showing that the trip is
compulsory and evidence of costs
o Council Tax – evidence that shows your current instalments
o Evidence of ‘priority debts’ – documents relating to IVA, DMP etc.
o Medication costs – evidence showing your ongoing monthly medication costs
o Evidence of car costs – insurance and tax
o Evidence of rent arrears – this can only be consider for your current property
o Evidence of disability costs not met by DSA
Full time UNDERGRADUATES please also provide:
o SFE Student Finance Breakdown Letter – this can be taken from your online personal SFE
account
o If NHS funded, NHS Bursary Award Letter and evidence of your non means tested Student
Loan – these can be taken from your online personal SFE/NHS account
PART-TIME UNDERGRADUATES please also provide:
o Student Finance Letter showing fee and course grant OR tuition fee loan
o Proof of your income – wage slips, benefits etc.
POSTGRADUATES please also provide, if applicable:
o Professional/Career Development Loan Agreement
o Evidence of how you otherwise intend to fund yourself – savings, parental support etc.
o Evidence of receipt of Postgraduate Scholarship Scheme
14. CONFIDENTIALITY AND DECLARATIONS – FOR ALL STUDENTS
 Applications are seen only by Plymouth University Student Funding staff.
 It may be necessary for additional supporting information to be sought from other
University staff in order to reach a decision.
 Plymouth University is a data controller in terms of 1998 legislation.
 The Student Funding Unit follows the University policy in matters of data protection.
The data requested in this form is covered by the notification provided by the
University under the Data Protection Act. Personal data will be used solely in the
department for statistical purposes and electronic record keeping.
 The data will not be passed to any third party without your consent, except when the
University is required to do so by law.
 Any formal enquiries concerning the use of data here should be addressed to the Head
of Gateway Services.
Signature
I declare that the information that I have given on this form is correct and complete to the best
of my knowledge.
I understand that giving false information will automatically disqualify my application and
may also lead to Plymouth University Disciplinary Procedures, resulting in possible expulsion
from the University, and I further undertake to repay any grants obtained by me, as a result.
Print your name
Your signature
Date
Please do not submit your application until you have checked that your information is
correct, and that you have attached all the relevant documents. Failure to provide full
documentation will result in automatic rejection.