2025 - Unemployed Bursary Fom (AMENDED)

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2025 - Unemployed Bursary Form

PART A: PERSONAL DETAILS
First Name :…………………………………………………………………………………………………….……………
Surname :……………………………………………….………………………………………………….………………
District/Town :.………………………………………………………………………………………………….………………
Course : ………………………………………………………………………………………………………………….
Major/s : ………………………………………………………………………………………………….………………
Duration of the Course :…………………………………….. Year
of Completion of Studies:……………………….….…………..
Date of Birth: __ __ / __ __ / __ __ __ __ ID Number:
Male Female
Gender:
African Coloured White Indian Other

Race:
Disability: YES NO
If YES, State nature of Disability: ....................................................................................................................................................
……………………………………………………………………………………………………….........
Name of Institution of Studies:…………………………………………………………………...............................................................
Student Number:
Home Address:
Postal Code
Cell phone Number:

WhatsApp Number:
1 of 5
YES NO
Have obtained a Bursary before?
If YES, Provide Details……………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………….
If any other Bursary/Bursaries received, then please specify the following:
Name of Bursary/Sponsor :………………………………………………………………………………………….................................
Amount :R…………………………………………………………………………………………..............................
Year Granted :…………………………………………………………………………………………................................
Years remaining (Including Service Obligation):…………………………………………………………………………………………..
If Serving Bursary Obligation, indicate Years Owing:……………………………………………………………………………………..
2 of 5
PART B: BURSARY INFORMATION
ONLY AVAILABLE TO UNEMPLOYED YOUTH WHO ARE RESIDING

IN THE PROVINCE OF THE EASTERN CAPE
• This Bursary is intended for Unemployed Youth between the ages of 18 and 35 years.
• This Bursary is awarded only to students who study full-time at a recognized Tertiary Institution (Public Institution)
• The Bursary payment will be effected directly to the Tertiary Institution and not to individual Bursary Holders.
• The Bursary is awarded on merit ad its renewal will be based on progressing to the next level.
• The Department will not pay any fees outstanding that are accrued to the Bursary Holder from previous year.
• The Bursary will cover the following: Registration and Tuition Fees, Accommodation and Meals, Stationery costs
• Applicants must have achieved a Bachelor Pass in their Grade 12 in order to qualify and receive this Bursary.
• Bursary Recipients who do not complete the specified course, who do not take up a position that was allocated to them
or who do not fulfil the Bursary Obligation, will have to repay with interest, all monies paid on his/her behalf.
• Please ensure that all relevant documentation is attached (please refer to enclosed checklist)
• Application to be completed in BLOCK LETTERS in the applicant’s own handwriting.
• Applicants are to complete Parts A, B, C & D
DOCUMENTS TO BE SUBMITTED WITH APPLICATION FORM

Certified Copies of:
1. South African ID
2. Matric or Equivalent Certificate
3. Any other Qualification relevant to this application
4. Documentary proof of Acceptance/Admission from a recognized Tertiary Institution (Public Institution) where intended
studies are to be undertaken.
5. Proof of Disability/ medical report and functional assessment report confirming your disability.
6. Proof of dependence to a Military Veteran
3 of 5
Give Names and Surnames of two (2) contactable References (Not relatives)
Reference 1: Mr/Mrs :…………………………………………………………………………………………………………………
Telephone Cell phone
Reference 2: Mr/Mrs :…………………………………………………………………………………………………………………
Telephone Cell phone
PART C: DECLARATION
ATTACH THE FOLLOWING DOCUMENTATION TO THIS FORM:
PART D: DECLARATION
• I have attached / enclosed all necessary supporting documentation, as required
• I shall ensure that any examination results from the November/December session will be submitted to the Department on
or before 13 January of the following year.
• I realise that failure to complete the Form and/or withhold Information and/or to supply requested documentation and/or
results can lead to the disqualification of the application.
• I understand that I will be required to sign a Bursary Contract/Agreement if this application is successful.
• I understand that if I do not complete the Course, I will be required to pay back to the Department all monies paid on my
behalf, by the Department, to the Institution.
I declare that the above information is true and correct.
Signed (Applicant):…………………………………… Date D D M M Y Y
Signed (Parent/Guardian):…………………………… Date D D M M Y Y

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202 Bursary Application Form for Unemployed

2025 - Unemployed Bursary Fom (AMENDED)

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2025 - Unemployed Bursary Form

Duration of the Course :…………………………………….. Year

Date of Birth: __ __ / __ __ / __ __ __ __ ID Number:

African Coloured White Indian Other

If YES, State nature of Disability: ....................................................................................................................................................

Name of Institution of Studies:…………………………………………………………………...............................................................

Cell phone Number:

If YES, Provide Details……………………………………………………………………………………………………………………….

If any other Bursary/Bursaries received, then please specify the following:

Name of Bursary/Sponsor :………………………………………………………………………………………….................................

Year Granted :…………………………………………………………………………………………................................

Years remaining (Including Service Obligation):…………………………………………………………………………………………..

If Serving Bursary Obligation, indicate Years Owing:……………………………………………………………………………………..

ONLY AVAILABLE TO UNEMPLOYED YOUTH WHO ARE RESIDING

DOCUMENTS TO BE SUBMITTED WITH APPLICATION FORM

Reference 1: Mr/Mrs :…………………………………………………………………………………………………………………

Telephone Cell phone

Reference 2: Mr/Mrs :…………………………………………………………………………………………………………………

Telephone Cell phone

I declare that the above information is true and correct.

Signed (Applicant):…………………………………… Date D D M M Y Y

Signed (Parent/Guardian):…………………………… Date D D M M Y Y

202 Bursary Application Form for Unemployed

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Date of Birth: / / ID Number: