INDIVIDUAL APPLICATION

Please check our Privacy Notice before beginning this application. The Privacy Notice gives details of how The Elizabeth Allen Trust uses your data. You should note you need to give consent to all four conditions listed below for us to be able to process your application.

Check your home address is within the area of benefit (London Borough of Barnet) before starting this application.

Make sure you complete the application in full and answer all questions carefully, as any missing information will delay the application process. There are guidance notes to help you fill in this form.

GDPR CONSENT

Your privacy is important to us and we would like to communicate with you about the Elizabeth Allen Trust and its activities. To do so we need your consent. By signing and submitting this application form you are confirming your consent to Elizabeth Allen Trust holding and processing your personal data for the following purposes (please tick the boxes where you grant consent):

I consent to Elizabeth Allen Trust holding and processing my personal data for the purposes of:

Reviewing and discussing my application for an educational grant at Trustees meetings.

Including my application details (without any name or contact details) in reports on grants made and financial returns.

Keeping my application details (without any name or contact details) for inclusion in research over time about our grant making.

I agree to being contacted by both email and post to process my application.

YOUR PERSONAL DETAILS

Title (eg. Mr, Mrs, Miss, Ms.)

Full Name

Other names by which you are known

Phone

Date of Birth

Day

Month

Year

Age

Multi-line address

Country/Region

Address

City

Zip / Postal code

How long have you lived in the London Borough of Barnet?

Please attach proof of your home address (eg. Council tax bill, utility bill, bank statement etc.

If you have lived at your current address for less than 5 years, please provide details of previous addresses, covering the last 5 years.

What is the name and address of the last school or college you attended?

What are the dates you attended?

YOUR FAMILY DETAILS

Please give your parent(s) full names and details of their occupation and income:

a) Father:

Name:

Occupation:

Income:

b) Mother:

Name:

Occupation:

Income:

Do either of your parent(s) receive any benefits?

If 'yes' please provide details of ALL benefits received:

Please attach copies of ALL benefits statements:

Give the names and ages of all other children / relatives who depend on your parent(s) for financial support:

Give the names and ages of any relatives who depend on you, the applicant, for financial support:

If you have been unable to provide family details please explain here:

PURPOSE FOR WHICH THE GRANT IS TO BE USED

What is the course you are studying or hope to study?

What is the name of the school, college or university you are at or wish to attend?

Date of the start of the course:

Day

Month

Year

How long will the course take?

Cost of the course fee each year:

Full details of any other expenses relating to the course that you will have to meet (eg. enrolment fee, examination fees):

Full details of any living expenses that you will have to meet (eg. accommodation, food, travel, course materials / books):

Are you eligible for a Student Loan / Student Finance?

If 'yes' give details:

Please attach photocopied evidence:

Details of other financial support already given (or applied for) - from parents or any other source / grant / bursary:

Do you currently earn income from a job?

If 'yes' how much do you receive per week?

Amount of grant you are seeking from Elizabeth Allen Trust:

If you are awarded a grant, to whom should the payment be made payable?

N.B. If you are under 18 the grant will normally be paid to your parent or guardian, who is asked to sign this form

Have you applied to this Trust before?

If 'yes' when did you apply?

How did you hear about Elizabeth Allen Trust?

QUALIFICATIONS ALREADY OBTAINED AND EXAMINATIONS PASSED

(GCSEs, NVQs, BTEC, A Levels etc. including grades)

WORK EXPERIENCE (including VOLUNTEERING)

Do you have any work experience or achievements to date (including Volunteering)?

FUTURE GOALS

Please give details of your future goals and aspirations and what you would like to do after you have completed your education:

HOBBIES AND INTERESTS

Please give details of your hobbies and leisure interests:

REFEREES

Please give the names and full addresses (including email addresses) of TWO people to whom we can apply for a reference. Before entering their name and contact details please make sure both people are willing to be contacted by the Trust to request a reference to support your application. One should be your most recent course tutor at the school, college or university you are now or have most recently been attending. The second reference should also be either from a school, college or university you have recently attended or a recent employer.

PLEASE NOTE TRUSTEES WILL NOT NORMALLY CONSIDER MAKING AN AWARD UNLESS TWO PROFESSIONAL REFERENCES HAVE BEEN RECEIVED.

REFEREE 1:

Name:

Address:

Postcode:

Phone:

Email:

How do they know you?

Please tick to confirm this referee has given you permission to use their contact details.

REFEREE 2:

Name:

Address:

Postcode:

Phone:

Email:

How do they know you?

Please tick to confirm this referee has given you permission to use their contact details.

ANY OTHER INFORMATION THAT WILL HELP YOUR APPLICATION

Please provide any further information about your present circumstances and / or circumstances about your past which will help the Trustees understand better why you believe you need financial help:

DECLARATION

I declare that all the information I have provided on this application is true to the best of my knowledge and belief and that I have not withheld any relevant information. I understand that if I have made any false statements of omitted any information from this application I am liable to have my application rejected or to repay any grant already given.

Signature of applicant:

Signature field is empty.

Name (in CAPITAL letters):

Date application completed:

Day

Month

Year

Ask your parent(s) or guardian to read through your application and then to sign in the boxes below.

Signature of mother:

Signature field is empty.

Name:

Signature of father:

Signature field is empty.

Name:

If you cannot provide these signatures, please explain why: