BURSARY APPPLICATION FORM

CONFIDENTIAL

The information shared on this application form will only be shared with Mulilo personnel
involved in the bursary selection process, and all private information will be handled as prescribed
in the Protection of Personal Information Act of 2020.

PLEASE NOTE:

1. This application is only open to the permanent residents of the Northern Cape and
specifically the following municipalities:
a. Siyathemba
b. Renosterberg
c. Emthanjeni
2. All completed applications must be submitted electronically to [email protected] by
5 October 2024.
3. No late applications will be considered.
4. Your bursary application will only be considered if this form is completed IN FULL and all the
required documentation is attached.
5. The submission of the bursary application DOES NOT guarantee a bursary.
6. All Shortlisted applicants will be subjected to a telephonic and a virtual face to face interview
before the final decision is made.
7. Successful applicants will be notified no later than the 10th of January 2025 of their
acceptance on to the Bursary Program.
8. If you have any queries relating to completing this form, please contact the Bursary
Administrator before the closing date:

Please note that if your family income combined is more than R180 000 per annum you will not be
eligible to apply for this bursary.

Via telephone:

021 685 3240 or 063 296 2908

Or via email to:

[email protected]

TYPE OF APPLICATION:

Please indicate the type of Bursary you are applying for below- in respect for the 2025 academic
year.

Undergraduate Program

Postgraduate Program

Distance Learning Program

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 Biographical Information
1 Name

2 Surname

3 Contact Number

4 Race (Black, Indian, Coloured, White etc.)

5 Gender

6 Do you have a disability?

No Yes
If yes, please provide details.

7 ID Number

8 Alternate Contact number (Indicate relation) Name of Alternative Contact:

Contact Number:

9 E-mail address

10 Home Address

11 Town

12 Province

13 Has anyone in your family been a Mulilo Bursary

Fund recipient? If yes – please list the full name of
the bursary recipient.

*Please note that this bursary is only open to applicants in the Northern Cape.

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 Application Details
14 IF APPLICABLE: CURRENT STUDENT
Are you an existing student – please send copies of
your result advice to date.
15 What year are you applying for?

16 Where are you registered?

17 What course are you registered for?

FIRST YEAR BURSARY APPLICATION

18 Have you applied at any University, TVET College

etc.?

Please supply the name of the Tertiary Intuition

which you applied at:

19 Application made for: First Choice

20 Application made for: Second Choice

21 Have you received provisional acceptance from the

institution? No Yes

22 If applicable, have you applied to the institution’s

residence?
23 Have your received provisional acceptance from
the institution? No Yes

Educational Information
24 Are you currently in Matric?

25 If you have already completed Matric, please

indicate which year.

26 Name of High School

27 Highest grade passed?

28 Do you have any other certificates or

qualifications? No Yes

If yes, please provide details.

3
 Family Biographical Information
29 Do you, or anyone in your family receive a monthly
government grant? If yes, please provide details: No Yes

If no, please indicate your monthly household R 0- R 2500 R 7500 – R 10 000

income:
Proof may be required R 2500 – R 5000 R 10 000 – R 12 500

R5000 – R 7500 R 12 500 – R 15 000

30 How many people are staying in your household?

31 Have you applied for another Bursary or NSFAS?

No Yes

If yes, please provide details:

Name of Bursary:

What does the Bursary Cover:

32 Are you on a waiting list for another Bursary?

No Yes

If yes, please provide details:

Details of the Bursary:

33 How many people are staying in your household?

34 How many siblings do you have (brothers/sisters)?

Please list their ages.

35 Do you have access to the internet?

No Yes

4
 Motivation Essay
Please provide a motivation of why you are applying for, and why you should be accepted into the
bursary programme.

Please cover the following topics:

1. Tell us about your family including your families’ current circumstances?
2. Tell us about yourself, your likes and dislikes and how your friends will describe you?
3. Give us an overview of your school life?
4. What are your hobbies?
5. What is your greatest passion?
6. What is the motivation behind your choice of studies?
7. What is your Plan B if your study application is declined?
8. If you have had a break between your Matric year and this application for further
studying, please tell us what you have been doing with your time at home?
9. Have you done any community work?
10. Tell us about one or more persons or people that have influenced you?
11. Describe the type of South Africa that you want to see in the next 10 year?
12. Why should you be given an opportunity to be part of the Mulilo Bursary Program?
13. What do you know about Mulilo Energy Holdings (PTY) Ltd?
14. What do you know about the renewable sector?

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*Please note: In submitting tis application your confirm that all the information herein is entirely
true and accurate. If any information requested is omitted or found to be untrue, this application
will be considered invalid. In addition, should any irregularities be discovered after the bursary has
been awarded, Mulilo reserves the right to withdraw the offer of a bursary.

Document Checklist – If you do not attach the below – your application will be seen as
incomplete and it will not be considered, and it will not be processed.
Copy of ID

Latest Report
or
Matric Certificate
or

Latest University Result’s

Proof of Application to the University, Technicon or

TVET to which you have applied to.

Motivation Essay – at least 1 full page

*Please note, if the documents listed above is not attached to your application, your application
will be viewed as incomplete, and it will not be processed.

I, the undersigned applicant, do hereby confirm that all the information provided herein is true
and accurate. I give my consent to Mulilo to utilize my personal information in accordance with
Mulilo’s External Privacy Policy.

Applicants Signature:_____________________ Date:__________________