Bursary Application Instructions

Instructions for filling in an online bursary application

The application form is divided into three parts on three separate pages:

Basic personal and contact information with details of where you have lived and studied to enable us to confirm your geographical criteria
Educational and work information
The final section which covers the course you are applying for

Extra qualification space is accessed by hitting the green +(plus) button

Please note: hitting the back button in your browser will result in losing your data and we will not be able to get in touch with you. Please use the contact page or download the application form if you are in any doubt.

What you will need to complete the form

You will need the following information to complete the application:

Your name, email and address details, showing that you satisfy the geographical criteria
Details of your academic results and the dates you secured them
Full details of the course you are applying for or already studying, including any details of financial awards and bursaries you have already received

Please take your time to complete as much detail as you can. We are looking forward to receiving your application.

Bursary application form

Please complete all the details that you can. The form is on three pages, which are accessed using the next button.

Important Information

Fields marked with a * are required. The form not be processed if these are not completed correctly. Please note: hitting the back button in your browser will result in losing your data and we will not be able to get in touch with you. Please use the contact page or download the application form if you are in any doubt, or email info@johnwestonstretton.org.uk if you do not hear from us in a few days.

Personal details

1. Name

First name

Last name

Phone No:

Email address

Is this your first application or a renewal? Please select from the dropdown box:

2. Date of Birth

Date of Birth

3. Address

Home Address (for correspondence)

Street Name & No:

Address:

Town/City:

County/Region:

Post Code:

Country:

Term-time Address (if different)

Please tick if your term-time address is the same as your home address

Street Name & No:

Address:

Town/City:

County/Region:

Post Code:

Country:

Please confirm that you are happy for us to store this information electronically (Data Protection Act 1998) .
Failure to accept this will mean we can't process your application.

Educational and Work Details

4. Schooling

School or College:

Dates:

Add another School or College...

Date:

Course:

Level (e.g GCSE):

Grade Achieved:

Add another course...

Include GCSE/A-Levels, vocational equivalents and any later qualifications. Begin with the most recent.

Contribution to School Life

Please give details of any activities , fund raising, sporting or otherwise in which you were involved at your school..

7. Current Employment

Occupation:

Course and Study Details

8. Name of College/University

If you are or will be attending College or University please complete this section

University/College:

Course start date:

Course end date:

What course will you be (are you) studying?

What qualifications will you receive?

Will you be residential or living at home?

Will you have any other source(s) of financial assistance?

Yes No

9. Previous Awards from this Trust

Please enter numbers only in the boxes

Year 1(£):

Year 2(£):

Year 3(£):

Year 4(£):

Year 5(£):

Previous Rewards

Add another previous award ...

Please list amounts of any previous awards.

Previous Awards from other Trusts

Please enter numbers only in the boxes

Year 1(£):

Year 2(£):

Year 3(£):

Year 4(£):

Year 5(£):

Add another previous award ...

10. Education or Further Education Grant

If you are in receipt of normal sources of student funds these are intended to cover normal student expenses. As there is considerable demand for the Charity's funds, it is MOST IMPORTANT for you to set out in details below any special expenses or financial needs you need to consider you have. Please set out an outline of your annual expenditure including: Board and Lodging, Travel, Books, Societies etc. Your application will not be considered if this part of the form is left blank and you fail to complete section 12 below.

11. If this is your first application, please indicate why you want to follow a career in medicine

12. Confirm Application

Confirm Application
This field is compulsory.
I am applying for a bursary from the above Charity and in doing so confirm that:

All the foregoing information is true.
No relevant information has been knowingly withheld.
Any false statement in the application may deprive me of all benefits from the Charity.
I will immediately inform the clerk of the Charity, in writing, if I withdraw from the course in section 8 above.
I have read and accept the Charities privacy statement that can be found at the bottom of the website’s home page.

Date of Application: