WIPHOLD BURSARY FUND

for aspiring Chartered Accountants, Actuaries and Engineers, Agriculturists

APPLICATION FORM

BURSARY SCHEME
Please read carefully before completing and returning application forms
NOTES
1. This document is not in any way an agreement or 5. The bursaries are awarded annually. Renewal is at the
commitment. discretion of the WIPHOLD Bursary Fund. Satisfactory
diligence and progress on the part of the student will be
2. The selection of learners is totally dependent on excellent taken into account when renewal is considered.
results obtained and the outcome of the selection process.
6. Successful applicants will be required to enter into an
3. The number of new bursaries available annually will depend agreement with the WIPHOLD Bursary Fund.
on funds available.
7. The closing date for completed applications is 30 November.
4. The value of each bursary will vary according to needs and
the availability of funds.

IMPORTANT INFORMATION TO BE NOTED BEFORE COMPLETING THE

APPLICATION FORM
1. The WIPHOLD bursaries are only available for African 5. The value of the bursary is dependent on availability of funds
learners. at the time.

2. Forms must be completed and returned to WIPHOLD 6. Successful applicants will be notified in January (after the
Bursary Fund, P O Box 87277, Houghton, 2041. (BEFORE matric results are known).
30 NOVEMBER).
7. Provisional successful applicants, based on grade 11 final
3. Your application form will only be considered if you have at results, will be notified by 30 November.
least 70% in Mathematics (NOT MATHS LITERACY)
and English (5 in the NSC Scale of Achievement). 8. Students will be required to do vacation work or corporate
social responsibility activities if and when required by
4. An aggregate of “A” or “B” are required. An aggregate of “C” WIPHOLD and its partners. This however is not guaranteed.
will be considered on a case by case basis only.

THE FOLLOWING MUST BE ATTACHED TO THIS APPLICATION

Failure to provide all required information in this section will jeopardise your application
1. Recent photograph. a) Why do you wish to become a Chartered Accountant /
Actuary / Engineer or Agriculturist? (select one)
2. Certified copies of: b) What, in your opinion, are the special talents required to
Ÿ Grade 11 results or Matric results if passed last year; succeed as a Chartered Accountant / Actuary /
Ÿ All appropriate testimonials, certificates or supportive Engineer or Agriculturist? (your selection)
documents; c) Why do you think you can succeed as a Chartered
Ÿ A copy of parents/guardian’s salary advice Accountant / Actuary / Engineer or Agriculturist ? (your
selection)
3. In your own handwriting on a separate piece of paper briefly
answer the following questions:
4. Write a short essay on yourself, your family and your career future plans.
Name of Applicant:

CONFIDENTIAL
TO BE COMPLETED BY PARENT OR GUARDIAN
NOTE: The parent/guardian may send the application direct to the WIPHOLD Bursary Fund to maintain confidentiality

1. Family contribution towards costs? If so, how much

2. What is the household income - after tax R per month (Father)

R per month (Mother)

TOTAL R Please attach copies of recent pay slips

3. Is there any other person - brother, sister or guardian - who can help? Please give details and amounts

4. Number of dependants: Children Other

Number of dependants at: School University Technikon College

5. How does the family survive when there is no income?

6. Personal particulars: Father Mother

Full names :

Training :

Occupation :

7. Please provide information about members of the family who hold qualifications (university/college/technikon)

NAME RELATIONSHIP QUALIFICATIONS

1)

2)

3)

8. Please provide any other important information that should be considered:

I declare that the information given is, to the best of my knowledge, correct and true.

Date: Signature of Parent or Guardian

 TO BE COMPLETED BY APPLICANT
PERSONAL DETAILS

Surname: Age years

Other names: Home language:

What name do you prefer? Nationality:

Residential address: Postal address:

Postal code: Postal code:

Province: Province:

Tel. No. Home - Code No. Email address:

Identity No. Cell No.:

Disability Indicate Details of Disability
Y N
What is the quickest way to contact you if we need to?

Other contact person - Name

Relationship to applicant:
Tel. No. Code No.
Fax No. Code No:

SCHOOL BACKGROUND
Last school attended or present school attending: Town:

Highest level attained: (e.g. Grd12, Grd 11) In what year?

PERCENTAGE NSC SCALE OF

SUBJECT (%) ACHIEVEMENT Usual class
Subject and position:
1.
Year-end How many
2. in class?
Percentage
3.
(%)
4.

5.

6.

7.

8.

Comparative marks GRADE 10 GRADE 11 GRADE 12

Percentage NSC Scale of Percentage NSC Scale of Percentage NSC Scale of
(%) Achievement (%) Achievement (%) Achievement

English

Mathematics
UNIVERSITY
Which Universities have you applied to?
(You must have applied to at least two.)

NB: One of these Universities must be the closest to your home

1. ____________________________________________

2. ____________________________________________

3. ____________________________________________

4. ____________________________________________

If you do not get enough funding, how will you cope?

Have you applied previously to WIPHOLD for a bursary? If yes, in what year?

I declare that the information given is, to the best of my knowledge, correct and true. I accept the conditions of the
bursary according to this application form.

Date Applicant’s signature

Attach a recent
passport size
photograph of
applicant

RETURN COMPLETED FORM TO:

WIPHOLD Bursary Fund
P O Box 87277
Houghton
2041
[email protected]

Closing date: 30 November.

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