PRIVATE BAG X04 NORTHLANDS 2116 FAX:011 483-0881 www.nfvf.co.za 87 CENTRAL STREET HOUGHTON 2198 TEL:011 483-0880 [email protected] FILM FUND: APPLICATION FORM FOR A NATIONAL BURSARY (INSTITUTIONS IN SOUTH AFRICA) FOR OFFICE USE ONLY Ref No. Date of Receipt CLOSING DATE: -8/< 201 at 12h00 Note: Extensions will not be granted The NFVF does not fund Live performance (Acting) studies TITLE SECTION 1: CONTACT DETAILS FIRST NAME ID NUMBER: POSTAL ADDRESS POSTAL CODE PROVINCE STREET ADDRESS POSTAL CODE PROVINCE TELEPHONE NUMBER FAX NUMBER CELLPHONE NUMBER E-MAIL 1 SURNAME SECTION 2 GENDER: Male Female RACE: Do you have any disability? Are you a South African citizen? If Not please state citizenship Are you a South African resident? If Not please state country of residence Is this your first application? SECTION 3: COURSE DETAILS 3.1 Intended Degree/ Diploma 3.2 Duration of course: 3.3 Current year of study and majors: SECTION 4: INSTITUTIONAL DETAILS 4.1 NAME OF THE INSTITUTION: 4.2 POSTAL ADDRESS POSTAL CODE 2 4.3 CONTACT PERSON IN THE DEPARTMENT TITLE SURNAME FIRST NAME TELEPHONE NUMBER FAX NUMBER CELLPHONE NUMBER E-MAIL SECTION 5: FINANCES 5.2 OTHER SOURCES OF FUNDING If you have applied for any financial assistance for the same purpose to any other source(s), please give full details Name of Company Amount Approved Awaiting approval TOTAL FUNDING RAISED 5.3 FAMILY INCOME 0867&203/(7($1'3522)72%(68%0,77(' FATHER: MOTHER: GUARDIAN: OTHER PLEASE STATE: 5.3 PLEASE STATE THE COMBINED PARENTS' INCOME: 3 Please submit the following documents with the application form A one page letter of motivation from the applicant stating why they need the funding, where they think their studies will lead them and how they think their chosen field will benefit their community andSouth Africa as a whole. Letter of acceptance from the institution or letter of acknowledgement of their application. Updated Study Fees breakdown from the institution for the year in which funding is required Certified copy of Identity Document. (Not later than three months) Latest Academic Results and Matric Certificate (only certified copies will be accepted) Parents' proof of income or other financial support if any i.e payslips together with a 2 months bank statement, proof of social grants. If independent, please also include your own payslip and 2 months bank statements. (only certified copies will be accepted) If you are studying on a loan or have received a bursary from other financial institutions please submit the relevant documentation. Submit only one copy of your application form including one copy of each document required. PLEASE NOTE: Do not fax or email applications. (Please post to the NFVF address) Failure to provide all requested information will lead to automatic disqualification of the application. No late application will be considered. The final allocation is subject to the NFVF verifying all the information submitted by the applicant. NFVF has previously experienced problems with contacting applicants at addresses and contact numbers provided. Should the applicant or recipient not be contactable for 2 months at the given address or contact number from the date of receipt or grant the application or the grant will be cancelled, should there be a change of contacts the onus is on the applicant to notify NFVF. The closing date for submission of applications is 31 JULY 2015, 12h00. Applicants will be advised of the decision in writing by 19 December 2015 No applications shall be returned to the applicant. Do not submit any extra material, e.g. videos, photographs, etc. (unless requested). NFVF bursaries are only available to South African citizens, applicants with permanent residency or those with refugee status. For any queries, please contact Lebohang Khunou, Tel: 011 483 0880 or [email protected]
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