OFFICE USE ONLYApplicant name

Student ID Date received

Thank you for applyingDetails entered onto this form will be transferred to computer. This information will be treated confidentially in accordance with the Data Protection Act, 1998.

Application receipt deadline: please see UWL website

Application FormUniversity of West London Scholarship Programme

FURTHER INFORMATION

If you would like additional information, please contact scholarships@uwl.ac.uk

All sections of this form must be completed.

Please write in CAPITAL letters, writing clearly in BLACK ink.

Full-time undergraduate students only

The University will be allocating 500 scholarships in total.

Meeting the eligibility criteria does not equate to an entitlement to a scholarship.

Early applications will be prioritised in the event of over subscription. Successful applicants will not be eligible to recieve any other bursary or scholarship directly or indirectly from the university during their first year of study.

ELIGIBILITYApplicants must meet the following criteria: Applicants must be from a household with an income of

less than 25,000 per annum. Applicants and sponsors are expected (where eligible) to have applied for means tested student support from Student Finance England and given consent to share information in order that their declared household income can be verified

Applicants must be due to start their undergraduate course in September 2015

Applicants must have accepted an offer of a place on an undergraduate course at the University of West London

Priority will be given to: Care Leavers Disabled students

The following applicants are not eligible for the National Scholarship Programme: Home students who are ordinarily resident in Scotland,

Wales and Northern Ireland International students NHS-funded students students directly continuing from one course to another

course (for example from a foundation degree or HND on to the final year of an honours degree)

students transferring from another Higher Education Institution

students undertaking a postgraduate qualification any other students whose fees are paid or part-paid

through a sponsorship arrangement part-time students studying at less than 25% intensity

of the full-time equivalent.

SCHOLARSHIP INFORMATIONThe value of the scholarship is 3,000 paid over three years and will consist of the following:

1. 1,000 credit, awarded per year of study for a maximum of three years towards the cost of study including learning materials and university catering outlets (via Aspire card) or transport costs.

A pro-rata amount will be delivered to eligible part-time students studying a minimum of 25% intensity relative to full-time equivalent.

HOW TO APPLYApplicants must complete and return the Application Form to the Scholarships Office by the date published on the website.

Applicants should enclose the following documents with their application form: Confirmation of offer from the University of West London Evidence of the total household income, either a P60

or benefits letter. This should include your and your sponsor(s). This would be the same evidence you supply to the Student Loans Company.

Notification of awards will be conditional on: confirmation that applicants have met the condition of

their offer and enrolled at UWL any evidence required as stated overleaf

Final allocation will be made once applicants have enrolled with the University.

Return completed Application Forms to:

TC37 Scholarships OfficeUniversity of West LondonSt Marys Road, EalingLondon W5 5RF

University of West London Scholarship Programme

Title (eg Ms/Mrs/Mr)

UCAS Number

Surname (Family Name)

First Name(s)

Date of Birth

University of West London Student ID Number

Date UCAS form submitted

Home address

Borough of residence Postcode*

Telephone Home Telephone Work

Telephone Mobile

e-mail

Course applied for

Name of previous school or college

Address of school or college

Postcode

PERSONAL DETAILS (PLEASE USE CAPITAL LETTERS)

*It is important that you list your postcode to ensure accurate assessment

Do you have an offer of a place to study at the University of West London starting in September 2015?

YES NO

Have you ever studied a Higher Education course before?

YES Where NO

Course

Have you applied for your student maintenance grant from Student Finance England?

YES NO

Are you a care leaver? (Please provide evidence from your local authority/social worker with this application)

YES NO

Do you have a disability (Please provide evidence from a suitable assigned professional)

YES NO

I declare that the information that I have given is correct and complete to the best of my knowledge.

I understand that giving false or misleading information will automatically disqualify my application.

Name (Capitals) Signature Date

D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y

University of West London Scholarship Programme

Application

uwl.ac.uk

OFFICE USE ONLY

HI evidence Bank details Eligible Not eligible