The John Mathews Educational Charity

Grant Application Form

Surname : ____________________________

Forenames  : ____________________________

Date of Birth : ____________________________

Home Address : ____________________________     

No of years resident at his address  : ____________________________

Are you on the electoral register for this address : ____________________________

Correspondence address ( If different to above) : ____________________________

Telephone number : ____________________________

Mobile number  : ____________________________

Email Address : ____________________________

Place of Birth : ____________________________

Have you, or a relative, previously applied to the charity for an award? Give details if Yes

Degrees / diplomas / Academic Qualifications already achieved. Please state university / college and dates awarded. : ____________________________

What is your current / proposed course and university / college of study? : ____________________________

Is your current / proposed course full or part time. If PT how many hours per week and weeks per year? : ____________________________

Date of commencement of current / proposed course (month & year) : ____________________________

Date of completion (month & year) : ____________________________

How do you propose to fund your course (ie student loan, parental help, grant etc) ? : ____________________________      

Please specify as fully as possible the costs of your course and any specialised materials or equipment required. Differentiate between expected course fees, materials, books and subsistence costs. : ____________________________

Please provide details of your financial circumstances. : ____________________________  

What level of support are you seeking from the Charity? : ____________________________

Are you receiving, or expecting to receive, funding from other sources? Please specify. : ____________________________

What are your career aspirations after completion of the course.? : ____________________________

How did you hear about the John Mathews Educational Charity? : ____________________________

I confirm that the above information is accurate and fully reflects my current circumstances.

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