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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. I also confirm I am enclosing Proof of Residence and a personal letter, as required in the Application Requirements section. If these documents are not seperately received by the Charity, your application WILL NOT be considered. They can be emailed to the address noted on the contact page.

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