Support - Hardship Fund – Information Sheet & Application Form 2013/14 Support Fund The Support Fund is used to provide discretionary financial help for students who get into financial difficulty during their course. Hardship Fund The Hardship Fund is available to students who are not eligible for the Support Fund. There is a smaller amount of money in the Hardship Fund, so circumstances must be exceptional for an award to be made. Students, who are not eligible for the student support fund, are automatically referred to the Hardship Fund. Who can apply for the Student Support Fund? All full-time and part-time (50% of equivalent full-time course) Northern Ireland and Great Britain undergraduates and postgraduate students can apply. Undergraduate students must have taken out their maximum Fee & Maintenance Loan entitlement. All students must demonstrate that they have organised sufficient funding for their course. The Support Fund is a discretionary fund and should not be viewed as a means to fund a course. For details of the University’s current payments options for tuition fees, please refer to http://www.qub.ac.uk/TuitionFees Any eligible student who has a particular financial need can apply. Prior to Submission of Application If you require any assistance completing your application form please contact: Connie Craig – Advice Centre Manager Student Financial Adviser 2nd Floor Students’ Union Email: [email protected] or Debbie Forsey Money Management Adviser 2nd Floor Students’ Union Email: [email protected] Application Process You can pick up an application form from the Income & Finance Office at the Student Guidance Centre. To download an application, please visit our website www.qub.ac.uk/StudentSupport Completed application forms with all documentation should be forwarded to or handed in at: Income & Student Finance Office, Student Guidance Centre, Queen’s University, Belfast, BT7 1NN Tel no 02890 972854, email [email protected] Every applicant will receive an email, to their QUB email address, confirming receipt of their application. Students will be advised by email of the decision within 4 weeks of submission of their application. However during peak periods, prior to Christmas and Easter, processing of applications may take longer. No decision will be discussed over the phone. Awards made by the Support or Hardship Fund do not have to be repaid. Students have the right to request a review of any decision in connection with their application. Reviews should be requested in writing, clearly stating the grounds for appeal and where appropriate, supplying additional documentary evidence to support the review process. Requests must be received within 14 days of the date of the original decision, addressed to the Chairperson of the Support Fund Committee, and returned to the Income & Student Finance Office, Student Guidance Centre. After you receive the outcome of your review, if you still disagree with the decision, you may appeal to the Support Fund Appeals Panel, who are responsible for handling the final appeal. You should clearly indicate how you believe an incorrect decision has been made. The Panel will review your case and inform you of their decision in writing. Additional Information You must provide evidence of your financial circumstances. Failure to provide the evidence requested will delay your application. Forms submitted without correct documentation or not completed fully will not be processed. You will be notified by email, to your QUB email address, about missing or incomplete documentation. You will have 4 weeks from the date of the email to provide this documentation otherwise your application will be deemed to have lapsed. Awards are assessed based on specific criteria, for full details of these please visit our website www.qub.ac.uk/StudentSupport Please note that students whose bank statements indicate gambling are not eligible for a direct payment. If awarded, depending on individual circumstances, a payment can be made to a 3rd party. Students in receipt of benefits, to which they are not entitled, are not eligible to receive an award. If you have an outstanding Emergency Loan or Institutional Bursary overpayment, any award from the Support Fund may be used towards repayment of this debt. Random checks will be made on individual applications and any found to be fraudulent will result in disciplinary action. There is no automatic entitlement to an award for any student. Awards are subject to money being available in the Fund. Students on occasion may be referred to other support services within the University. These may include: Money Management Adviser, Debbie Forsey [email protected] Connie Craig, Advice Centre Manager, Financial Adviser [email protected] Disability Services [email protected] Learning Development Service [email protected] Counselling Service [email protected] SUPPORT FUND / HARDSHIP APPLICATION 2013/14 For Office Use Only Student Support No: Personal Details Student Number: Name: (print) Home Address: Date of Birth: Contact Tel No: Bank Account Details* Name(s) of Account Holder(s): Account Number Sort Code Name and Address of Bank *Awards are paid by BACS directly into your bank account so it is vital that you give the correct details Course Details Course Title: Are you: Undergraduate Are you: Full-time If you are a Nursing Student are you: February Intake Is this your final year? Yes Is this your second undergraduate degree? Yes ☐ ☐ No No ☐ ☐ ☐ ☐ ☐ Postgraduate Part-time September Intake ☐ ☐ ☐ Is this a placement year? Yes ☐ No ☐ Paid ☐ Unpaid ☐ Are you spending the year overseas as a compulsory part of your course? (If you have elected to study, work overseas, please select No for this question) Yes ☐ No ☐ For Office Use Only Receipt Emailed O/S Info Requested O/S Info Rec’d Complete Referral Reason Student Loan Have you taken out in this academic year your full loan & grant entitlement (both maintenance and fees) from Student Finance? (Only applicable to UG and PGCE students) Tuition Fee Loan * Yes Maintenance Loan * Yes ☐ ☐ No No ☐ ☐ ☐ ☐ N/A N/A * If yes to any of the above, please provide the FULL Student Finance Notification & Breakdown Marital Status Single ☐ Married ☐ Civil Partnership ☐ Divorced ☐ Lone Parent ☐ ☐ Co-habiting Accommodation details Do you live: 1. in rented accommodation 4. with parents or guardian ☐ ☐ 2. in a hall of residence 5. with your partner or spouse ☐ ☐ 3. Home Owner 6. Other * ☐ ☐ * If Other please give details: If you live with your partner or spouse are they: Working ☐ Studying ☐ In receipt of benefits ☐ Other * ☐ If Other please give details: Dependants We understand persons with dependants to be those with personal responsibility for the care of a child, the care of a person with an incapacitating disability and/or the care of a dependent elderly person. Please list anyone in your household who is financially dependent on you. Name Relationship to You Date of Birth Do you have a disability? (only tick yes, if you are registered with Disability Services) Are you in receipt of Disabled Students Allowance (DSA)? Yes ☐ No* Yes* ☐ No ☐ ☐ *If No and you have a disability, please contact Disability Services for further information and to discuss eligibility. If you wish to apply for funding towards the cost of a diagnostic assessment, please contact Disability Services. Student & Partner’s Declaration of Income Documentation Required Checklist (Please attach COPIES not originals) £ Yearly Income SLC Maintenance Loan SLC Maintenance/Special Support Grant Parents Learning Allowance Please tick the boxes (if applicable) to show that the information has been provided Student Finance Financial Notification & Finance Breakdown for 13/14 Student Finance Financial Notification & Finance Breakdown for 13/14 Student Finance Financial Notification & Finance Breakdown for 13/14 Adult Dependants Grant Student Finance Financial Notification & Finance Breakdown for 13/14 Child Care Grant Student Finance Financial Notification & Finance Breakdown for 13/14 Other Grants Please provide relevant documentation Nursing/Social Work Bursary DHSSPS Notification Letter and Breakdown Income Support/JSA/Other means tested benefits Letter from Benefits Office Housing Benefit Letter from Housing Executive Working Tax Credit 2013/14 Full Notification from HMRC Child Tax Credit 2013/14 Full Notification from HMRC Childcare Element of Working Tax Credit 2013/14 Full Notification from HMRC Maintenance Payments Please provide relevant documentation QUB/Del Stipend Please provide relevant documentation Other Income (please specify) Please provide relevant documentation Personal take home earnings Wages/Pay advice slips/P60 Partner’s take home earnings/ benefits Wages/Pay advice slips/P60/Set of accounts if self-employed/letter from Benefits Office Total Income £ 3 Months Recent Bank Statements, for all accounts held in your name (Not Mini Statements)* SHOULD BE INCLUDED WITH YOUR APPLICATION ☐ *All transactions must be visible Student Finance NI Financial Notification 2013/14, please also include breakdown, these can be downloaded from: www.studentfinanceni.co.uk using Customer Reference Number Student & Partners Expenditure Documentation Required Checklist (Please attach COPIES not originals) £ Monthly Please tick the boxes (if applicable) to show that the information has been provided Rent or Mortgage Tenancy agreement/letter from mortgage provider/proof of payments on bank statements ie standing order to Landlord, with Landlord’s name visible on a minimum of 2 months statements. Rates Notification from Land & Property Services Childcare costs Confirmation from the Nursery/Crèche/Registered Childminder, detailing weekly charge on headed paper. If your child care provider is a Registered Childminder please provide copy of their registration certificate. Please note, no costs will be allowed for non-registered childminders. Disability costs not covered by DSA (please specify) and/or Medical costs Please provide relevant documentation Debts Do you have any debts? Yes* ☐ No ☐ Have you previously or are you currently using pay day loans as a source of finance? Yes* ☐ No ☐ If yes, to either of the above, please give details and provide supporting documentation (do not include student loans or your main bank overdraft) Company Reason for loan Balance owed Minimum monthly payment Are you still using this source of credit? Travel Costs Student Weekly Travel Costs Yes * ☐ Do you travel by Public Transport? No ☐ *If yes, state: Cost of return journey (see below) £ ________ & Number of return journeys _________ For students living away from home, the cost of one return weekly journey will be allowed. If you have more than 1 return journey in a week, please provide an explanation: Yes * ☐ Do you travel by Car? *If yes, state your mileage per week: No ☐ __________ miles per week Assessments can generally only include car costs for students who require a car because of disability, students with dependants, those attending certain placements. Those who can’t use public transport for a particular reason, please outline below. Partners Weekly Travel Costs (If applicable) Yes * ☐ Do they travel by Public Transport? No ☐ If yes, state: Cost of return journey (see below) £ ________ & Number of return journeys _________ Yes * ☐ Do you travel by Car? *If yes, state their mileage per week: No ☐ __________ miles per week For Office Use Only Student’s weekly travel cost - Public transport Cost of return journey Student’s weekly travel cost -car Mileage per week Partner’s weekly travel cost - Public transport Cost of return journey Partner’s weekly travel cost - car Mileage per week £ No of journey allowed Assessment period Total travel cost £ Total travel cost of Student & Partner £ £ £ £ No of journey allowed £ £ £ Course costs, do not include Tuition Fees, Books and Print Credits/Photocopying Costs Please provide details: Cost incurred: £ Provide evidence of cost, i.e. receipt; please note no costs will be allowed unless receipts are provided. Exceptional costs i.e. repair/replacement of essential equipment or costs arising as a result of unforeseen circumstances. Please provide details: Cost incurred: £ Provide evidence of cost, i.e. receipt; please note no costs will be allowed unless receipts are provided. PERSONAL STATEMENT Please state below why you are in financial difficulty and why you believe your situation to be exceptional and to merit additional support. Please only include details which are relevant to FINANCIAL hardship. ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ STUDENT DECLARATION – please read and tick ☐The information given in this form is correct and complete to the best of my knowledge ☐ I have checked and enclosed ALL ESSENTIAL relevant documentary evidence. ☐ I have enclosed copies of 3 months recent bank statements (not mini-statements) ☐ I have enclosed a copy of my Student Financial Notification & Breakdown for 2013/14 (if applicable) ☐ I have enclosed copies as requested as information will not be returned. ☐ I understand that random checks will be made on individual applications and any found to be fraudulent will result in disciplinary action I understand that the information contained in this form and attachments are held for the purpose of assessing my application for Support Funds. I understand that this information may be disclosed to the Department for Employment and Learning and/or the Student Loans Company, in accordance with the Data Protection Act. I further understand that third parties referred to in my application may be contacted to seek independent verification of the information supplied. Signed: __________________________________ Date: ____________________________________
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