SFSO FORM A

(New Applicants)

UNIVERSITY OF CAPE COAST

STUDENTS’ FINANCIAL SUPPORT OFFICE
Telephone: 036 219 6721 Email: [email protected]

APPLICATION FOR SPONSORSHIP

2023 – 2024
SECTION A – APPLICANT’S BACKGROUND INFORMATION
(Complete all questions using BLOCK/CAPITAL letters only. Where it is not
applicable indicate N/A. Your application will not be processed if you leave any
question unanswered
1.Full name, as it appears on the University’s documents
Surname: Other Name(s):

2. Date of Birth 3.Gender (Male/Female) 4. Student ID #

(DD/MM/YYYY)
5.Place of Birth: Town Region 6. Nationality:
7. Home Town: 8. District: 9. Region:
10. Residential Digital Address in School: 11. Permanent Digital Address

Telephone #:

UCC Email:

Alternative Email:

12. Address to which correspondence regarding this Current Level of Level of Study for
application should be sent: Study 2023-2024

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13. Academic Programme of Study (eg. B.Ed, B.Sc, College: School/Faculty:
M.Phil,
Ph.D.)

14. Department: 15. CGPA (for the past academic year

of study)
16. Mode of Study: (Regular/Distance) 17. Affiliated Hall of Residence

18. Schools attended with dates:

Full Name of School Town/District/ Dates of
Region Attendance
(eg.
2011-2013)
SHS

Other

University

19. Indicate the mode by which you gained admission to the University
Mode Month/Year Candidate Index Number Total Aggregate
Score/CGPA

SSSCE/WASSCE

Private Candidate

Diploma

Mature Entrance
Exams
Bachelors

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Masters

SECTION B: INFORMATION ON FINANCES

20. Estimate how much you will need to spend during the 2023-2024 academic year. These
expenses should be relevant to your studies only.
Academic Fees (University Approved Fees and Charges) Use this GH¢
year’s amount
Residential / Housing / Hostel (for 1 st and 2nd Semester) GH¢

Living expenses (for 1st and 2nd Semester) GH¢

Books GH¢

TOTAL GH¢

21. Indicate below the amount of money that you expect will be available to you from each of
the following sources for the 2023-2024 academic year
Personal GH¢

Parents / Guardian (if you are not employed and do not expect any GH¢
money from your parents/guardian, please attached a sworn
affidavit from them explaining why they will not give you anything
towards your educational expenses
Feeding (for 1st and 2nd Semester) GH¢

Benefactor GH¢

Part-time employment GH¢

SSNIT / Student Loan GH¢

Scholarship (specify) GH¢

Other (specify) GH¢

TOTAL GH¢

22. How much funding do you require? This amount is the difference between your total
estimated expenses
(Question 20) and what you expect will be available to you from the sources indicated
(Question 21)

GH¢

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23. What type of Financial Support are you seeking? (Tick as many as are applicable)

Full Scholarship

Partial Scholarship

Work-study programme

Other (specify)
SECTION C: INFORMATION ON SPONSORSHIP
24. If you have applied or intend to apply for other types of financial support for the 2023-
2024 academic year, please state

The type of financial support Amount (GH¢) The agency to which application
(eg. Scholarship, bursary, etc.) has been,
or, will be made (eg. Ghana
Government, Common Fund, MTN)
1.

2.

3.

25. If you have been promised any financial support for the 2023-2024 academic year
from any Institution, Organization, Benefactor, or Individual, please state:

Name and address of the Institution, Organization, The Amount (GH¢) of

Benefactor or Individual Financial Support
1.

2.

3.

Will the said sponsor contribute

to provide financial support for
your education?

If YES, what is the expected

total amount of sponsorship per
year?

GH¢

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SECTION D: FOR STUDENTS WITH DISABILITIES
27a. Type of Disability (eg. Visual 27b. Do you qualify to receive Government
Impairment) Bursary for disability?

SECTION E: APPLICANT’S EMPLOYMENT HISTORY (If applicable)

28. Period of Employment (dd/mm/yyyy)

From: To:
29. Name, address and contact information of current or last employer

Are you on salary during the period of your State your total gross income
studies?

SECTION F: TO BE FILLED BY APPLICANTS WITH DEPENDANTS

30. Provide the following information on your dependents

Surname Other Name(s) Ag Level of Education Relationshi
p
e

31. If married, provide the following information about your spouse

Full Name:
Surname Other Name(s)
Level of Education Occupation

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Name and address of Employer

Annual Total Gross Income (Salary and income from other sources. Attach evidence)

SECTION G: ADDITIONAL INFORMATION

32. You may provide additional information to support this application. This information can
include awards received, information on others who help sponsor may provide additional
information to support this application. This information can include awards received,
information on others who help sponsor your education, and other information on your
financial situation. (Additional paper may be used if required).

SECTION H: ESSAY

Please attach separate typed essay on your personal statement in Times New Roman Front size 12
and 1.0 spacing, between 300 and 600 words of not more than one typed page each.

Please submit copies of the following (do not send the originals):

• Evidence of income of parent/guardian.

• Applicant’s most recent pay slip if applicable.
• Any other supporting documents that you believe will assist in processing of your
application.

Consent

Please circle one (want/not want) below:

a.If I am not successful I would want / not want my personal data to given to another donor.

Confidentiality of records

All records and conversations between the financial support applicant, his/her family and staff
of the Financial Support Office are confidential and entitled to the protection ordinarily given
because of the fiduciary relationship. The University assures the confidentiality of student
personal and educational records in accordance to the rules and regulations of the University
and the Data Protection Act, 2012 (Act 843). No information concerning the student’s financial
support records will be released to anyone outside the Financial Support Office/Committee
without the student’s permission or by an order of the courts. A student who wishes to obtain

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access to his/her financial support record shall submit a written request to the Financial
Support Administrator.

Declaration

It is important that your eligibility for student financial aid be based upon accurate
information

I do hereby declare that to the best of my knowledge all my information given in this
application are true and made in good faith.

Signature of Student Date

Note: Misrepresentation in any material form renders the applicant null and void. Any award
made on misreprentation shall be withdrawn or refunded by the
applicant, and he/she may be prosecuted. The truth, rather than lies, will get you Financial Aid.

Applicant’s biological parents

Parents Name Occupations Annual Income

33a.
Father

33b.
Mother
SECTION C 1 – (TO BE COMPLETED BY PARENT/LEGAL GUARDIAN – person so far responsible
for financing the education of the applicant)
34a. Full Name 34b. Digital Address.
Surname:
…………………………………………………………….
Telephone #
Other
Name(s):………………………………………………….
34c. District of residence 34d. Region of residence:

35a. Occupation. 35b. Name and address of employer.

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 36. Annual Total Gross Income. (GH₵)

(Salary and income from other sources. Please substantiate with a recent official salary slip,
pension slip or audited financial statement. If unemployed, please attach evidence to show
how you survive and your sources of funds for survival). Please note that this information is
necessary and if not provided the SFAO will disqualify your application.

Other income that you receive from any of the under listed sources:

Pension:
GH₵

Investment returns:
GH₵

Rental income:
GH₵

Contribution from other sources:

GH₵

DECLARATION TO BE SIGNED BY PARENT OR GUARDIAN

It is important that your dependent’s eligibility for student financial support be based
upon accurate information.

I do hereby declare that all the information given above is true and made in good faith.

Signature or thumbprint of parent/guardian ……………………………………

Date………………………

Where parent cannot read nor write

Name of
witness……………………………………………………………………Position…………………
….
GUARANTOR

This portion should be signed by someone of high repute who is expected to know the
applicant officially/personally. The application will not be valid if the guarantor below is not
signed. If the declaration proves to be false, the application will be rejected; if the falsity is
detected after admission, the student will be dismissed.

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I certify that the photograph endorsed by me is the true likeness of the applicant.

Mr./Miss./Mrs.………………………………………………………… is officially/personally
known to me.

I have inspected his/her documents(s) and I am satisfied that they are genuine and the

name that appears on them is the same as that by which he/she is officially/personally

known to me.

Name……………………………………………………………………..……………………………
………………….…

Status……………………………………………………………………………………………………
………………...…

Address……………………………………………..…………………………………………………

…………..…………

…………………………………………………………………………..………………………………

…………………...

Signature………………………..…………………….………..
Date……………...……………………………..

Note: Misrepresentation in any form or manner shall render the application null and void.
Any awards made based on a misrepresentation shall be withdrawn or refunded by the
applicant, or he/she also may be prosecuted.

The University of Cape Coast reserves the right to cancel the applicant’s application if false
or incorrect information is supplied.

Thank you for your cooperation.

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 FOR OFFICE USE ONLY

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