Fillable MINING QUALIFICATIONS AUTHORITY 2022 EMPLOYED BURSARY APPLICATION FORM (South Africa Office of the Chief Justice)

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MINING QUALIFICATIONS AUTHORITY 2022 EMPLOYED BURSARY APPLICATION FORM (South Africa Office of the Chief Justice)

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MQA/LP-SP/04/038 Revision: 02 Approved: COO Date: 30/07/2020
www.m
q
a.or
g
.za
www.mqa.org.za
MINING QUALIFICATIONS AUTHORITY
2022 EMPLOYED BURSARY APPLICATION FORM
Closing date: 30 September 2021
Please Note:
This form must ONLY be completed by applicants who are PRESENTLY employed within the Mining and
Mineral Sector.
The Employed Bursary is not available for applicants on a structured Internship Programme or Work
Experience (P1/P2) Programme. These programmes are not considered as employment for the purpose of
this bursary.
GUIDELINES AND INSTRUCTIONS
1. APPLICATION FORM
The Applications Form is an electronic fillable PDF format with drop-down menus for ease of completion.
DO NOT change the format of the form to a normal PDF or Word format.
Do not complete the form by hand.
NB: It is advised that you complete the form on a computer or laptop as not all smartphones or
tablets have “PDF” functionalities to process fillable PDF forms.
2. SUPPORTING DOCUMENTS
1. Certified copy of a valid South African Identity Document.
2. Full Academic Record – (if applicable).
3. Acceptance letter from a university or university of technology (if applicable).
4. Letter of consent from employer to engage MQA bursary scheme (on company letterhead and signed by
immediate Supervisor (Very important).
Only provide the documents requested above (where applicable)
Certifications must not be older than 3 months.
“Pictures” of documents taken with cell phone or tablet will be rejected – all supporting documents must
scanned in and properly named.
3. EMAIL OF APPLICATION FORM AND SUPPORTING DOCUMENTS
E-mail your application form and supporting documents ONLY to: Bursaries@mqa.org.za.
Multiple e-mails from the same applicant will disqualify the application.
NB: Late and incomplete applications forms will be disqualified.
MQA/LP-SP/04/038 Revision: 02 Approved: COO Date: 30/07/2020
Page 2 of 3
SECTION A - PERSONAL DETAILS OF APPLICANT
ID Number
Surname
Full Names
Gender Title
Equity African
Coloured
Indian
White
Disability
Yes No
(State nature of disability hereunder)
South African Citizen Yes No
If No, please state:
Name of High School attended
Year Matriculated
Street:
Home Address
(Province of
origin)
Suburb:
City/Town:
Postal Code:
Home Province
NB: Important for
reporting
p
urpose, please
select correct information
Local Municipality
District Municipality
Location
Urban Rural
Contact Number
Alternative
Number
Email address
Name of Employer
Employer SDL Number
Employer Address
Street:
Area:
City/Town:
Postal Code:
Name of Immediate Supervisor
Contact telephone of Supervisor
Email address of Supervisor
_
_
_
_
MQA/LP-SP/04/038 Revision: 02 Approved: COO Date: 30/07/2020
Page 3 of 3
SECTION B.2 - TERTIARY EDUCATION: 2022 ACADEMIC YEAR
Details of Institution and qualification you will studying in 2022
Type of Institution
Name of Institution
Name of Qualification
Qualification Type
Academic Status in 2022
Student Number, if you are already studying
Are you currently on Internship or P1/P2 program Yes No
Will you be completing your qualification during 2022? Yes No
SECTION D: DECLARATION
By submitting this form and supporting documents, I declare that all the information provided is TRUE
AND CORRECT, and I am aware that providing incorrect information and documents will result in the
disqualification of my application. I also acknowledge that the awarding of a bursary is at the absolute
sole discretion of the MQA, and the MQA reserves the right not to award me the bursary.
I further authorise the MQA to access, from the university, university of technology and my employer,
any necessary relevant information/documents that has a bearing on this application, and continue to
access information/documents should my bursary application be successful. I furthermore authorising
the MQA to share my personal information with any institution/organisation/state department for
reporting and research purposes.
Names and Surname
Date
_
_
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MINING QUALIFICATIONS AUTHORITY 2022 EMPLOYED BURSARY APPLICATION FORM (South Africa Office of the Chief Justice)

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Completed 27 September 2021

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