1. finance
2. grants, scholarships and financial aid
3. scholarships

Metsimaholo Local Municipality Executive Mayor’s
Bursary Programme
2015 BURSARY APPLICATION – INFORMATION LETTER
Dear Applicant
Please read the instructions before completing the application form.
The Executive Mayor’s Bursary Programme grants bursaries to students in areas of studies relevant to:
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Chemical Engineering
Civil Engineering
Electrical Engineering
Finance (Accounting)
Horticulture
Industrial Psychology
Information Technology
Internal Auditing
Law
Management Studies
Marketing and Communication
Mechanical Engineering
Plumbing
Project Management
Quantity Survey
Risk Management
Welding
Who may apply?
Metsimaholo Local Municipality students interested in studies at public South African Universities, Universities of Technology and FET
Colleges for degree, diploma and certificate programmes in the above fields of study.
Preference is given to applicants who want to study at but not limited to the North-West University (Vaal Branch), Vaal University of
Technology, and Flavius Mareka FET College (Sasolburg).
Bursary includes: Registration and tuition.
Main selection criteria: Academic merit and financial need.
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General Instructions:
The completed application form must be submitted on/before 28 November 2014 if you want to be considered for a bursary for
2015.
Onl y application forms completed in full and accompanied with the required supporting documents will be considered.
Onl y application forms that are mailed to us by surface mail will be considered. Faxed or emailed forms will NOT be considered.
Onl y applications from Metsimaholo Local Municipality students will be considered.
Please apply timeously for admission for next year to the educational institution of your choice.
Please apply for Financial Aid when you apply for admission at tertiary institutions.
Applicants are advised to apply for as many other bursaries as possible as the Executive Mayor’s funding is limited.
Documents to be submitted with the application form (if and where applicable):
A certified copy of this year’s Gr 12 June exam results or an appropriate progress report if no examination was written.
A certified copy of your final results if you have completed your NSC (matric), or any year of study.
Yo ur academic record if you are currently studying at a tertiary institution.
Proo f of income/salary* of parent(s) or guardian (e.g. payslip/letter from employer/sworn statement).
If guardian/none of the parents works, a sworn affidavit (from SAPS) should be supplied.
Proo f of r esidence (co p y of r ates & ta xes , w ate r, elect ricit y, etc. )
A certified copy of your South African Identity Document (ID).
Submitted Application Forms: Acknowledgement of Receipt
The Office of the Executive Mayor annually receives hundreds of application forms and it will therefore not be possible to acknowledge
receipt of completed forms. All applications will be considered. Successful applicants should expect an sms/telephonic reply by 16
January 2015. Please inquire only after 31 January 2015 if by that time you still have had no answer. Successful applicants must
provide their year-end results as soon as available, and no later than 23 January 2015.
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Metsimaholo Local Municipality Executive Mayor’s
Bursary Programme
Bursary Application Form 2015
PLEASE READ THE INFORMATION LETTER CAREFULLY
BEFORE COMPLETING THIS FORM
NB. Please mark your answer with an “X” where applicable. Example:
I am a South African (RSA) citizen:
No
Yes X
Mail/deliver the completed application form with supporting documents to: Executive Mayor’s Bursary Programme, PO Box 60, Sasolburg, 1947
Section 1: Personal Information
Id no
Are you a South African citizen?
Surname
Yes
Y
Y
First names
E-mail address
Cell numbers
No
Date of birth
Your own:
D
D
M
M
Y
Y
Relative:
Home tel number
Postal address
Province
Population group
Do you suffer from any
disability?
Is your family home in a
rural area?
Postal code
African
No
Asian
Yes
Coloured
No
Yes
White
Describe your
house
Formal/
permanent
Gender
Female
Informal/
shack
Male
If “yes”, please
specify
Section 2: Academic Information
What are you doing this year?
Gap year
School
Full time tertiary studies
Full time work
If employed full-time, provide
monthly income
R
Highest educational qualification already obtained
(e.g. Grade 12 or N4)
Name of the institution or school you’re currently
studying at
Provide full details of your current study course
(e.g. Grade 12; BCom 1st year)
● School results: Provide your results in the relevant spaces below (Grade 11; June 2014, Pre-lim (if available) and Final Grade 12 (NSC) (if applicable).
Please note: Mathematics: The difference between “Mathematics” and “Mathematical Literacy” is important. Applicants who do/did mathematical literacy
must leave the Mathematics space blank.
Physical Science: Learners who do not present Physical Science as subject will leave the Physical Science space blank.
Other subjects: Use the spaces for your other subjects. Provide the subject name and results. Please list your best subjects first.
Please submit proof of results with the completed form.
Pre-Lim Grade 12
Final Grade 12 Results
Final Grade 11 Results
June Grade 12 Results
Subjects
Results
(NSC/matric)
Home
First
Additional
English
Language (HL)
Language (FAL)
Mathematics
Physical Science
Life Orientation
Other Language:
HL
FAL
Mathematics Paper 3 (if applicable)
Mathematical Literacy (if applicable)
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● Latest University or College Results (e.g. First year June university results)
Subjects
%
Subjects
%
Proposed study course next year: (School grade, Diploma or Degree,
e.g. Grade 12 / ND Chemical Engineering / B Com Marketing)
Type of institution where you intend studying
full-time next year
High School
Agricultural College
FET College
University of Technology
Universit y
Campus:
Name of university, college or school where you
intend studying full-time next year
Grade or year of study next year
(e.g. Grade 12 or 1st or 2nd or NCV 3 or Hons)
Provide your student
number (if available)
Which career do you intend following on completion
of your studies?
Applied:
Mention any other bursaries you have applied for as well as any
bursary grants which have already been confirmed
Where have you heard about the
Executive Mayor’s Bursary
Scheme?
Church
Study
institution
Confirmed (state amount):
Internet
Newspaper
Teacher
Community
leader
Radio
Local Friend
Library
Other
Section 3: Family Information
● Father/ stepfather
Surname:
Marital status
Employed?
Married
No
Yes
Full names:
Divorced / Separated
Pensioner?
No
Yes
Total income (salary, wages, pension, etc.) per month?
(before deductions)
Surname:
● Mother /stepmother
Marital status
Employed?
● Guardian
Married
No
Yes
Pensioner?
Employed?
Married
No
Yes
Full names:
Never married
Deceased
Widowed
Yes Highest academic qualification?
No
Please include
proof of income
R
Full names:
Never married
Deceased
Widowed
Yes Highest academic qualification?
No
Total income (salary, wages, pension, etc.) per month?
(before deductions)
Widowed
Please include
proof of income
R
Divorced / Separated
Pensioner?
Deceased
Highest academic qualification?
Divorced / Separated
Total income (salary, wages, pension, etc.) per month?
(before deductions)
Surname:
Marital Status
Never married
Please include
proof of income
R
● Providethenamesand surnames of other members of your family who are living at your home (not mentioned above):
Name
Relat ionship
(e.g. grandmother)
Which category does the person fall
under? (pre-school / school learner /
Tertiary student / adult
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Does the person have any
income from any source?
(provide rand per month)
What kind of
Income is this?
(e.g. wages / salary /
grant / pension)
Section 4: Supporting Documents: Checklist
The following supporting documentation must accompany your application:
Please check the box on the right of each item that is included. Your application will not be considered without the relevant
documental
proof.
1.
A certified copy of this year’s June results or your
latest results
if you are not studying this year. (Tertiary
students have to include their complete academic record.)
2.
A certified copy of your NSC/matric results (if you have completed school).
3.
A certified copy of your ID document.
4.
Certified copies of recent pay-slips of your parent(s)/guardian.
5.
A copy of the latest audited financial statements or a sworn affidavit if your parent(s)/guardian is/are self-employed.
6.
Sworn affidavits if your parent(s)/guardian is/are unemployed.
7.
A certified death certificate or a sworn affidavit in the case of deceased parent(s)/guardian/spouse.
8.
A certified recent pay-slip of your guardian if you reside with your guardian even though your parent(s) is/are still alive.
9.
A certified copy of the divorce certificate if your parents are divorced.
10. If your parents are separated a sworn statement from one of them confirming their separation.
I hereby declare that all the information given in this form and the included documents are true and accurate.
_______________
_________
Date:……………………………………
Applicant’s signature: ………………………………
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