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 full 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. I also confirm that I have read the Privacy and Data Protection Policy on the application requirements page, and agree to my data being used as described therein.
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