2016-2017 application form

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Student Financial Support
Application 2016/17
Funds are available for students with a household income below £28,000.
Please see our website - www.midkent.ac.uk - for more information.
Please complete ALL relevant sections.
Whenever you see i refer to the GUIDANCE NOTES - See page 4
Please complete the checklist before returning your form and ensure you supply the
relevant evidence. Please supply photocopies as originals cannot be returned.
If you would like help with this form please contact the Student Financial
Support team on 01634 383300 or email learnerservices@midkent.ac.uk
Funds are limited and we cannot guarantee to support every
application therefore we recommend that students apply as early
as possible.
Please be aware that applications received after 26/8/16 may
take up to 4 weeks to process.
Section 1: Student Details
If you are/were under 19 on the 31/08/2016 and are in care, a care leaver, in receipt of Income Support, in receipt of Disability Living Allowance and
Employment Support Allowance i please call 01634 383300 before continuing with this application.
The 19+ Advanced Learning Loan Bursary (19+ ALLB) is only available to students with a confirmed offer of a loan from the Student Loan Company.
Title
First name
Last name
Home telephone number
Address
Mobile telephone number
Email address
Age on 31/08/2016
Date of birth
D
D
M
M
Y
Y
Y
Do you live with your parents?
Postcode
Student Loan Ref No.
Y
Yes
Section 2 : Course Details
No
Do you live with your partner/spouse? Yes
No
i
Course title
Campus:
Medway
Maidstone
Section 3 : Course Related Costs
Please do not purchase equipment prior to applying for support. THERE WILL BE NO REFUNDS. i
Please indicate the financial assistance you require:
UK trips / Essential uniform and equipment*
Food**
ITEMS PURCHASED FROM DISCRETIONARY FUNDS REMAIN THE PROPERTY OF MIDKENT COLLEGE
* As agreed by the Faculty Director and excluding students in receipt of 19+ Advanced Learning Loan or on a concession
** To be eligible for assistance with food the household income must be below £16,190, this includes 16-18 year old students, students in receipt of a 19+ Advanced Learning Loan
and students aged 19-24 with an EHCP or LDA.
Section 4 : Transport to College
If you require help with travel what type of transport will you use?
Bus
or Train
From which station or bus stop do you intend to start your journey?
Travel support is only available where the student lives further than 1.5 miles walking distance from the College. i
If you usually travel by local authority taxi then please ring 01634 383300 for assistance.
Please be aware that there is a £25 administration fee (payable by the student) should the bus pass be lost.
Should you lose your train ticket please report this to the station that issued it. A replacement can take up to 10 working days to be issued.
Section 5 : Status
Please tick whichever applies to you:
Under
in Section 6.
Under 19 and living independently without parental support (you must have been
name or working). If this applies to you please provide the evidence requested in Section 6 in your name. (If you are under 19 and in receipt of Income
Support please call 01634 383300)
19+ If this applies to you please provide the evidence requested in Section 6 in your name.
Evidence of earnings / other income
If you or your parents are in receipt of any of the following please enclose evidence requested. We cannot accept your form without proof of income.
If applying for 19+ ALLB please provide all household income as detailed in section 6.
Please supply copies as originals cannot be returned.
Evidence of income i
Wage - Employed / P60 dated April 2016 or last 3 months payslips if paid monthly or 12 weekly payslips
Wage - Self employed / last accounts submitted
Job Seekers Allowance - Entitlement / Award notice dated after 1st April 2016
Employment Support Allowance - Entitlement/Award notice dated after 1st April 2016
Working Tax Credits - Award notice for April 2016 - April 2017 (All pages) or last annual review received
Child Tax Credit - Award notice for April 2016 - April 2017 (All pages) or last annual review received
Income Support or Income Based Employment Support Allowance - Entitlement / Award notice dated after 1st April 2016
Disability Living Allowance / Personal Independence Payment - Entitlement / Award notice dated after 1st April 2016
Pension Guaranteed Credit -- Entitlement / Award notice dated after 1st April 2016
Universal Credit - Entitlement / Award notice dated after 1st April 2016
Change of circumstances i
ort irrespective of previous income.
Such changes might include but are not limited to; redundancy, family break up or bereavement of a household member.
If this applies to you please tick here and provide a covering letter explaining your change of circumstances
If no tax credits are received please provide either a birth certificate or child benefit letter with the student’s name on.
Section 7 : Childcare
Please tick if you require help with the cost of childcare
If you do not require help with childcare go straight to Section 8
Care to Learn: Students under the age of 20 on the 31st of August 2016 who need childcare support should apply via the national Care to Learn scheme.
For more information please call 0800 1218989. Applications must be completed online at www.gov.uk/care-to-learn/overview.
Your childcare provider must have a current OFSTED rating of Grade 3 or above. Please provide the OFSTED registration number:
Students are responsible for any additional childcare costs which are accrued outside timetabled lessons, although reasonable time for travelling to and from
College may be funded. i
Any Nursery Education Grant (NEG) funded session (for 2/3/4 year olds) must be used on the student’s college days.
A maximum support level of £50 per day or £30 per half day per child is allowed and any amount over this will remain the responsibility of the student.
Name of child
Child’s date of birth
Name of nursery provider/childminder
Address, phone number and email address
For continued childcare assistance you must maintain an attendance rate of 90% or above.
i
Section 8 : Attendance agreement
Financial Support can only be provided to students whose attendance remains above 90% of timetabled lessons.
Where a student is in receipt of travel assistance and attendance drops below 90% they will not receive further travel support until their attendance improves
Where a student is in receipt of childcare support and attendance drops below 90% they will be liable for their childcare invoices until their attendance
improves to above 90%.
STUDE N T N A ME
Date
D
D
M M
Y
Y
Y
Y
STU DE N T S I GN ATUR E
Section 9 : Declaration
I declare that the information I have given on this form is complete and correct.
I understand MidKent College has the right to make independent checks of the information I have supplied and any deliberately misleading or false information
will result in a demand for repayment of all monies or the return of all equipment purchased with these monies.
I understand payment will only be made if my attendance is consistently 90% or above.
I have read and understood the notes entitled ‘Guidance Notes’ and the other sections of this application.
I understand that the information will be held on computer for College/University purposes and that the Data Protection Act applies.
STUDE N T N A ME
Date
D
D
M M
Y
Y
Y
Y
STU DE N T S I GN ATUR E
CHECKLIST
Work through this checklist before returning your application.
I have completed all relevant sections of this form
I have provided photocopied evidence of household income. Please note if you are
sending tax credit award notices, we require all pages
I have read and understood the Attendance Agreement and Declaration and signed both to
agree my understanding
If I have indicated a change of circumstances I have included a letter detailing these changes
Please return this form to: Student Financial Support, MidKent College, Medway Road, Gillingham, Kent ME7 1FN
GUIDANCE NOTES—to be used when completing the application form
Section 1: Personal Details
If you fall into one of these groups you may be entitled to an award from the Guaranteed Bursary scheme. Please contact Student Financial Support
on 01634 383300 to discuss the help available. Students applying for a 19+ Advanced Learning Loan Bursary must have a confirmed offer of a loan from the
Student Loan Company.
Section 2: Course Details
apply for please contact our Careers Advisers on 01634 383300 for impartial careers advice.
Section 3: Books and Equipment
The College funds will only support goods and services to the value set by the Faculty Director. Refunds will not be processed.
Section 4: Transport
The 1.5 mile distance from the College campus is measured using Google Maps’ walking directions and your home postcode.
Please be aware that there is a £25 administration fee (payable by the student) should the bus pass be lost.
Should you lose your train ticket please report this to the station that issued it. A replacement can take up to 10 working days to be issued.
Section 6: Income
If you or anyone in your household are in receipt of any form of income and/or benefit please provide evidence as listed in the table below:
Evidence Required
Proof of earned income
P60 dated April 2016 or last 3 months wage slips if paid monthly or 12 weeks
payslips if paid weekly
Proof of income from self-employment
Evidence of last accounts showing total income
Evidence Required
Income-based Job Seekers Allowance (JSA)
Income Support (IS)
Entitlement / Award notice or letter from Job Centre Plus stating name, address and
benefit type and the amount dated after 1st April 2016.
Employment Support Allowance (ESA)
Universal Credit
Pension Guarantee Credit
Working Tax Credit or Child Tax Credit
Tax Credit Award Notice for period 6/4/2016 - 5/4/2017. ALL PAGES
or last annual review received.
Change of Household Financial Circumstances
thresholds, please tick this box and include a covering letter with your application outlining the changes you have experienced. The Student Financial Support
Section 7: Childcare
Information Service (FIS). Please provide the childcare providers registration number on the application form.
Any Nursery Education Grant (NEG) funded sessions (for 2/3/4 year olds) must be used on student’s college days.
Responsibility for Payment
Although the College will contribute to childcare costs, the main agreement will remain between the childcare provider and the student. Where payment is
withheld due to non-attendance the student remains responsible for the costs accrued. Please be aware that should you arrange childcare before receiving
For continued childcare support students must maintain attendance of above 90%.
The maximum award for childcare per student per year is £7500.
If you have questions or would like help with completing the application form please contact Student Financial Support on 01634 383300 or pop
into the Information Zone where staff will be able to help.
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