GOVERNMENT OF SEYCHELLES

GOVERNMENT OF SEYCHELLES

MINISTRY OF EDUCATION

POST SECONDARY INSTITUITIONS

BURSARY ALLOWANCE APPLICATION FORM PAID BY

AGENCY FOR SOCIAL PROTECTION

AGENCY FOR SOCIAL PROTECTION Application for Bursary

It is important that you read the application form carefully before completion. Whilst you are filling out this form, please note that "Guardian" refers to the adult(s) that you live with, and who are responsible for you. This person might be your stepmother, brother, grandmother, etc

Student Information Surname:

Name(s):

NIN: District

Address: Tel. No.:

Parent / Guardian's Name. _______________________________________________________

Parent Contact Number(s): _______________________________________________________

Please tick which of the following mode of payment you want your allowance to be paid by

Airtel Money

Cable Money

Bank Transfer

Banking Details if Bank Transfer Please fill in the bank account details. (Authorisation should be given if it is not your personnel account & a copy of your Bank Account must be provided.)

Bank:

Account Number:

Branch:

Account Holder:

Is the Account In your Name (Please Tick)

Yes: No:

If No to Above please make sure you supply the certified authorisation form provided by the bank. If not then the

Agency will not be able to process your application until it is received.

Education

In which post-secondary education institution are you enrolled?

Seychelles Maritime Academy (SMA) Seychelles Business Studies Academy (SBSA) Sey. Institute of Agriculture & Horticulture (SIAH) Seychelles Tourism Academy (STA) Seychelles Institute of Teachers Education (SITE)

National Institute for Health and Social Studies (NIHSS) School of Advance Studies (SALS) Seychelles Institute of Technology (SIT) Seychelles Institute of Art & Design (SIAD)

What is the name of the course for which you are enrolled? ________________________________________________________________________________ Which year of post-secondary studies are you in?

First

Second

Third

Fourth

Declaration I hereby certify that the information in this application is correct

Student Signature & Date

Student Support Signature & Date

The information that is present on this form shall be forwarded to the Agency for Social Protection to facilitate payment of the bursary allowance. Note that all application of bursary received AFTER the 31st of May 2017 will not be backdated.

Director of Professional Centres Signature & Date

Comments:

PC Official Stamp

IMPORTANT NOTE:

Document to be provided

Check list:

Tick if Present

1)

Copy of Identification Card (For Students)

2)

Copy of Bank Details Card

3)

Original Certified (Stamped and Signed by bank) Bank Au-

thorisation form (If Account for funds to be transferred into

is not under the students name)

Student's Signature: Guardian's Signature:

Note for the above in cases where "2" is applicable there's no need to seek Bank Authorisation in point "3". Please ensure that all necessary documents are attached to your form to prevent any undue delays in processing your application

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