APPLICATION FOR A BURSARY FOR THE RSA/CUBA MEDICAL .
RSA/CUBA-2017Page 1 of 5APPLICATION FOR A BURSARY FOR THE RSA/CUBA MEDICAL TRAINING PROGRAMME - 2017The information required on this Application Form must be furnished in full. Failure to do so may jeopardise the applicant’schances of obtaining a bursary. Certfied copies of all documents as outlined on Page 5 should be attached.NB: APPLICANTS MUST BE PREPARED TO UNDERGO SCREENING FOR CHRONIC DISEASESFILL IN THIS APPLICATION FORM IN CLEAR BLOCK LETT ERS AND MARK WITH AN (X) WHERE NECESSARYA: PERSONAL INFORMATIONTITLE:Mr.Mrs.MissOtherSURNAME:NAMES rFemaleDATE OF BIRTH:ID NO.:AGE:DISABILITY:YesNoIf YES, please specicifyE-MAIL ADDRESS:MOBILE NUMBER:TELEPHONE NUMBER:RESIDENTIAL ADDRESS:POSTAL ADDRESS:MUNICIPALITY: .DISTRICT: . WARD NO.:
RSA/CUBA-2017Page 2 of 5B:FAMILY BACKGROUNDFULL NAMES OF PARENT(S) /GUARDIAN:STATE RELATIONSHIP TO PARENT(S)/GUARDIAN:RESIDENTIAL ADDRESS:POSTAL ADDRESS:PARENT/GUARDIAN’S CONTACT NO.:PARENT/GUARDIAN’S OCCUPATION:NAME AND ADDRESS OF EMPLOYER:TOTAL INCOME:C:FINANCIAL SUPPORTARE YOU CURRENTLY RECEIVING A BURSARY FROM ANOTHER SPONSOR ?If YES, please state the name of the funding institution and the sum you are receivingYESNOHAVE YOU PREVIOUSLY RECEIVED A BURSARY LOAN FROM THE GOVERNMENT OR / ARE YOU CURRENTLYRECEIVING A BURSARY FROM THE GOVERNMENT ?YESNOIf so, please state the name of the funding department and the sum
RSA/CUBA-2017Page 3 of 5D:EDUCATIONAL QUALIFICATIONSMATRICULATION CERTIFICATE:Year Obtained:Name of the School:Province:Municipality:Town:LIST ALL YOUR GRADE 12 LEARNING AREAS OR SUBJECTS. THOSE WITH SYMBOLS MUST CONVERT THEM ASPER CONVERSION TABLE AND INSERT THEM IN THE SCORE COLUMN:LEARNING AREAS OR SUBJECTS LEVELS SYMBOLS (HG/SG) SCORE1.SYMBOLS HIGHER GRADE STANDARD GRADE2.A763.B654.C545.D436.E327.F218.TOTAL SCORESE:CONVERSION TABLECURRENT FIELD OF STUDY (if already studying)Year of Study:Institution:Student No.:
Page 4 of 5F:RSA/CUBA-2017CONTACTABLE REFERENCES (Please Provide Two)NAME:RELATION:TEL. NO.:NAME:RELATION:TEL. NO.:G:DECLARATIONI certify that the information given above is true and correct and that I have read and understood the conditionsgoverning the granting of bursary loans in the event of a bursary loan awarded to me.I also undertake to abide by the rules and regulations of the Programme and also undertake to complete theduration of the MBCHB Course.I am prepared to enter into a contracual agreement with the Department of Health to serve back the number ofyears sponsored in a facility determined by the Department.SIGNATURE OF APPLICANTDate: .SIGNATURE OF PARENT or GUARDIAN (if minor)Date: .FOR OFFICE USE ONLY.Head of Department (or Designee)Date: .
Page 5 of 5RSA/CUBA-2017RETURNING THE BURSARY APPLICATION FORMThe following documents must accompany your bursary application form Letter of ApplicationCertfied copies of your identity document (ID). NB: Students must not be older than 25 years in ageCertified copy of your Matric/Grade 12 CertificateRecent Salary Advice/Payslip of parent (s) or GuardianIf parent (s) or Guardian is unemployed please submit an affidavitProof of Residence from your local municipality or local Traditional Leader/Chief SHORTLISTED CANDIDATES WILL BE REQUIRED:1.To Submit A Valid Passport.2.To Submit Ten (10) 4x5 cm ID photos3.To Submit A Police Clearance Certificate indicating a Negative Criminal Record4.To undergo medical screening at health facilities prescribed by the Department of HealthRETURN YOUR APPLICATION BY HAND TO THE FOLLOWING ADDRESSES OR TO YOUR NEAREST HOSPITAL:EHLANZENI DISTRICTPHYSICAL ADDRESS66 Anderson StreetMbombelaENQUIRIES: Justice Ravhura @ Tel. 013 755 5161Hoxani Sub-District Offices:Hoxani Multi-purpose Community Centre, MkhuhluR536 Kruger RoadENQUIRIES: Linky Khoza @ 013 708 0046GERT SIBANDE DISTRICTPHYSICAL ADDRESS39 Jan van Riebeeck StreetErmeloENQUIRIES: Sydwell Gwebu @ Tel. 017 811 1642NKANGALA DISTRICTPHYSICAL ADDRESSPiet Koornhof BuildingEmalahleniENQUIRIES: Halifax Aphane @ Tel. 013 658 1012THE CLOSING DATE IS THE 31st MAY 2017FOR ALL OTHER ENQUIRIES CALL: MARIE MHLABANE/SIPHO MAHLANGU @ 013 766 3372 / 3024
APPLICATION FOR A BURSARY FOR THE RSA/CUBA MEDICAL TRAINING PROGRAMME - 2017 The information required on this Application Form must be furnished in full. Failure to do so may jeopardise the applicant’s chances of obtaining a bursary. Certfied copies of all documents as outlined on Page 5 should be attached.
a1. A Department of Health or NHS Bursary (excluding the Social Work Bursary paid by the NHS Business Services Authority) Yes. No. a2. A bursary from Student Awards Agency Scotland (SAAS) Yes. No. a3. A Healthcare Bursary from the Department of Health (DoH) for Northern Ireland. Yes. No.
a Practice Placement Expenses (PPE) claim form. As the household income threshold for the NHS Bursary is higher than the income threshold applied for the Placement Bursary, all BSc Speech and Language Therapy students who would ordinarily be considered under the Placement Bursary schem
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Visual Arts Bursary Award 2021: Guidelines for Applicants 4 1. About the Visual Arts ursary Award 1.1 Objectives and priorities of the award The objective of the Visual Arts Bursary Award is to support individual professional artists and curators to develop their practice. There are two strands to the award: Strand 1: Artists
Student Financial Support Placement Bursary 2015/16 . by submitting a Practice Placement Expenses (PPE) claim form. As the household income threshold for the NHS Bursary is higher than the income threshold applied for
which consistency of bursary schemes fund impact on retention of students; to assess how socio economic background of students impact on retention of students in public secondary schools; to determine the level at which public sensitization on bursary schemes impact on retention of students. The study was guided by the theory of socialist .
1. About the Visual Arts ursary Award 1.1 Objectives and priorities of the award The objective of the Visual Arts Bursary Award is to support individual professional artists and curators to develop their practice. There are two strands to the award: Strand 1: Artists The objective of the Visual Arts Bursary Award Strand 1: Artists is to support
additif a en fait des effets secondaires nocifs pour notre santé. De plus, ce n’est pas parce qu’un additif est d’origine naturelle qu’il est forcément sans danger. Car si l’on prend l’exemple d’un champignon ou d’une plante toxique pour l’homme, bien qu’ils soient naturels, ils ne sont pas sans effets secondaires.
