Fillable PN1 2021/22 New Student Application for Student Finance (London Institute of Management and Technology)

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PN1 2021/22 New Student Application for Student Finance (London Institute of Management and Technology)

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1
SFW/PN1F /2122/EN/A
2021/22
PN1
New Student Application
for Student Finance
We welcome applications in Welsh. This won’t lead to a delay in our response.
You can also apply online at: www.studentnancewales.co.uk
Your forename(s)
Your surname
If you have applied for student nance before,
please provide your Customer Reference Number
You should complete this form if you are starting one of the following courses:
• a full-time or sandwich course of higher education;
• a full-time Initial Teacher Education (ITE) course;
• a diploma or degree course in a health related discipline and you are eligible to apply for
an income assessed bursary from the National Health Service (NHS), Department of Health
(DoH) or the Student Awards Agency Scotland (SAAS).
We have provided guidance notes to help you so please refer to these each time you
see this icon.
You will have to send evidence with your application whenever you see this icon.
Details about the evidence can be found in the guidance notes.
Before completing this form, you should read the Privacy Notice on page 25 of the
accompanying notes.
You may be eligible for a bursary or scholarship. In order for a university or college to determine
and pay any bursary or scholarship to which you may be entitled, we will share some of your
personal, nancial and course details as well as information about your eligibility for student
nance with them. For more information about this, read our Privacy Notice. Please contact the
university or college if you require further information about their bursaries and scholarships.
Deadline
To make sure you receive your rst payment at the start of term, you must return this form and
all of the evidence we need by 4 June 2021. We will do our best to process your application
as soon as possible, however if the deadline date has passed your rst payment may not be
ready for the start of term.
If your application form is returned more than 9 months from the start of your academic
year it won’t be processed, and you may lose your full entitlement to student nance for this
academic year.
facebook.com/SFWales twitter.com/SF_Wales
2 SFW/PN1F/2122/EN
Section 1 - nance available
If you start your course on or after 1 August 2018 you could get:
• Tuition Fee Loan • Maintenance Loan • Welsh Government Learning Grant • Special Support Grant
If you started your course before 1 August 2018 you could get:
• Tuition Fee Loan • Maintenance Loan • Fee Grant • Welsh Government Learning Grant
• Special Support Grant
Extra help
You can also apply for additional student nance:
• Adult Dependants’ Grant • Childcare Grant • Parents’ Learning Allowance
• Disabled Students’ Allowance • Bursaries and Scholarships • Travel Grant
You can apply in 5 easy steps
(Depending on your circumstances you may not need to complete all the steps)
Step
1
For all students
• Complete sections 2–6;
• Remember if you are applying for a loan you need to tell us how much you want by
completing the loan request section on page 23;
• You do not need to complete section 6 if you are only applying for a Tuition Fee Loan
and/or a Fee Grant.
If you only want to apply for a Tuition Fee Loan, Fee Grant or a Maintenance Loan that is not based
on household income you can go directly to Step 5. If you are starting a full-time distance learning
course on or before 1 August 2018 (for reasons not relating to disability) you can only apply for a
Tuition Fee Loan and a Fee Grant.
Step
2
For students who want to apply for student nance based on household income
• Complete sections 7 and 8;
• If
you want to apply for Special Support Grant complete section 9.
Step
3
For students who have dependants
• Complete section 10;
• You should complete this section if you have any children or adult dependants and
want to apply for nancial help in relation to them.
If you are a single independent student go directly to Step 5.
Step
4
For students who want to apply for student nance based on household income
• Complete section 11;
• Depending on your answers in section 11 you may need to ask your parent(s) or
partner to provide details about their income in section 12 so we can work out what
your full entitlement to student nance will be.
Step
5
For all students
• Make sure you have read and signed the Terms and Conditions on pages 31 and 32
• If you asked someone to complete section 12, make sure that they have signed their
declarations on page 41.
3SFW/PN1F/2122/EN
Continued
Section 1 - nance available
Other student nance available
Childcare Grant (CCG)
If you want to apply for CCG you’ll need to:
• complete and return this form and
• complete an Application for Help with Childcare
Costs (CCG1).
You can download the CCG1 form at:
www.studentnancewales.co.uk
Tick the box if you want us to send you a
CCG1 form instead.
Disabled Students’ Allowance (DSA)
If you want to apply for DSA you’ll need to:
• complete and return this form and
• complete a Disabled Students’ Allowance
Application form (DSA slim).
You can download the DSA slim form at:
www.studentnancewales.co.uk
Tick the box if you want us to send you a
DSA slim form instead.
What if I have further questions?
If you have further questions you can:
• visit: www.studentnancewales.co.uk or
• call us on 0300 200 4050
Where do I send my form?
Return this form to us:
Student Finance Wales
PO Box 211
Llandudno Junction
LL30 9FU
Remember to pay the correct postage.
4 SFW/PN1F/2122/EN
Section 2 - personal details
a Personal details
Title
Mr Mrs Miss Ms
Forename(s)
Surname
If you have a double-barrelled surname please ensure you put both parts of your surname with a hyphen in between,
if applicable.
Any other names you
may be known by
Sex
Male Female
Date of birth
Day Month Year
Please complete the following questions with the details exactly as stated on your birth certicate or passport.
Place of birth
(the name of the town or village)
Nationality
b1
Identity evidence details
Do you hold a valid UK passport?
Yes No
if ‘No’ go to b2
We will share the passport details you provide with HM Passport Oce to conrm that
they’re valid.
Provide the following details exactly as stated on your UK passport, which must be
currently valid and not expired (this is the easiest way for you to verify your identity and
means you do not need to send us your passport).
Passport number
Forename(s)
Surname
Date of issue
Day Month Year
Date of expiry
Day Month Year
b2
If you don’t have a valid UK passport, you must send your original non-UK passport or
Biometric Residence Permit or your original UK birth or adoption certicate.
c
Previous loans
Have you ever had any loans from the Student
Loans Company Limited (SLC)?
Yes No
if ‘No’ go to d
If ‘Yes’, are you behind with the repayments?
Yes No
5SFW/PN1F/2122/EN
Section 2 - personal details
Continued
d
Contact details
Please give your current home address. If you know it, please also give your term-time
correspondence address.
Home address
Postcode
Home phone number
Term-time address
Postcode
Date on which you will move to your term-time address
Day Month Year
Mobile phone number
Email address
What language would you like us to use on the letters we send you?
English
Welsh
e Did you move to Wales wholly or mainly for the
purpose of receiving Higher Education?
Yes No
if ‘Yes’ contact Student
Finance Wales
f
Armed Forces
Are you a member of the Armed Forces serving outside Wales?
Yes No
Are you a family member of someone in the Armed Forces serving
outside Wales? (for example: spouse or child)
Yes No
g
Current relationship status
Tick one box:
Single
Living with a partner
Married/civil partnership Please give the date of marriage/civil partnership
Day Month Year
Separated
Divorced/dissolved civil partnership
Widowed/surviving civil partner
6 SFW/PN1F/2122/EN
Section 3 - residence
If ‘No’ go to a4
a1
Nationality
Are you a UK national?
No
if ‘No’ go to a2
Yes now go to b1
a2 Are you an Irish citizen?
No
if ‘No’ go to a3
Yes – have you been resident in
the UK and
Islands for the three years prior to the
rst day of the rst academic year of
your course?
No
if ‘No’ go to a3
Yes
now go to b2
a3 Are you the family member of a UK
national, and both you and your UK
national family member were living:
• in the UK on 31 December 2020, after
moving to the UK from the EEA or
Switzerland
on or after 1 January 2018; or
• in the EEA or Switzerland on 31
December 2020?
No
Yes – have both you and your family member
been resident in the UK, Gibraltar, EEA
or Switzerland for three years prior to
the rst day of the rst academic year
of your course?
No
If ‘No’ go to a4
Yes
now go to b2
a4 Have you been granted settled status
or pre-settled status under the EU
Settlement
Scheme?
No
if ‘No’ go to a5
Yes – settled status
Please provide your share code
now go to b2
Yes – pre-settled status
Are you an EU national and have been
resident in the UK and Islands for
three years prior to the rst day of the
rst academic year of your course?
No
if ‘No’ go to a5
Yes
Expiry date of pre-settled status
Day Month Year
Share code
now go to b2
7SFW/PN1F/2122/EN
Section 3 - residence
Continued
a5 Are you the child of a Swiss national? No
if ‘No’ go to a6
Yes – were you resident in the UK, Gibraltar,
EEA or Switzerland for three years
prior to the rst day of the rst
academic year of your course?
No
if ‘No’ go to a6
Yes – provide your:
Expiry date of pre-settled status
Day Month Year
Share code
If your parent or step-parent
has settled or pre-settled status
under the EU Settlement Scheme,
provide their:
Date of birth
Day Month Year
Expiry date for pre-settled status
Day Month Year
Share code
now go to b2
a6 Are you or your:
• husband, wife, civil partner; or
• parent(s), step-parent; or
• child, step-child
an EEA or
Swiss national who is working, or
has worked or is looking for work in the UK?
No
if ‘No’ go to a7
Yes – I have been working or
looking for work in the UK.
Yes – my family member has been working
or looking for work in the UK. My
family member is my:
husband/wife/civil partner
parent(s)/step-parent
child/step-child
8 SFW/PN1F/2122/EN
Section 3 - residence
Continued
a6 continued
Have you been resident in the UK,
Gibraltar, the EEA or Switzerland for the
three years prior to the rst day of the rst
academic year of your course?
No
if ‘No’ go to a7
Yes – provide details of
your/your family
member’s employment. You should also
provide details of your previous study.
If you/your family member are currently
working, will you/your family member
continue to work during your studies?
No
if ‘No’ go to a7
Yes – provide details:
Provide your:
Expiry date of pre-settled status
Day Month Year
Share code
now go to b2
Provide your family member’s:
Date of birth
Day Month Year
Expiry date of pre-settled status
Day Month Year
Share code
now go to b2
9SFW/PN1F/2122/EN
Section 3 - residence
Continued
a7 Are you the child of a Turkish Worker
who is working in the UK?
No
if ‘No’ go to a8
Yes
– has your Turkish
worker parent/
step-parent been granted extended
Leave to Remain in the UK after 31
December 2020 by the Home Oce?
No
if ‘No’ go
to a8
Yes – were you and your Turkish
worker parent/step-parent
living in
the UK by 31
December
2020?
No
if ‘No’ go to a8
Yes
now go to b2
a8 Do you have settled status in the UK,
that was not granted under the EU
Settlement Scheme?
No
if ‘No’ go to a9
Yes – provide your:
Home Oce reference
number
Date latest status granted
Day Month Year
now go to b1
a9 Have you or your:
• husband, wife, civil partner; or
• parent(s), step-parent
been granted refugee status by the UK
government?
No
if ‘No’ go to a10
Yes – provid
e your:
Home Oce
reference number
Date latest status granted
Day Month Year
Date this status is due to expire
Day Month Year
Have you lived outside the UK and Islands
since your latest status was granted?
No
go to section 4
Yes
if ‘Yes’ go to b3
10 SFW/PN1F/2122/EN
Section 3 - residence
Continued
a10 Have you or your:
• husband, wife, civil partner; or
• parent(s), step-parent
been granted ‘leave to remain’ as a
Stateless Person?
No
if ‘No’ go to a11
Yes – provide your:
Home Oce reference
number
Date status granted
Day Month Year
Date this status is due to expire
Day Month Year
Have you lived outside the UK and Islands
since your latest status was granted?
No
go to section 4
Yes
if ‘Yes’ go to b3
a11 Have you or your:
• husband, wife, civil partner; or
• parent(s) or step-parent
been given:
• ‘leave to enter or remain’ in the UK on the
grounds of family or private life; or
• ‘leav
e to enter or remain’ in the UK following
a failed application for ‘leave to enter or
remain’ on the grounds of family or private life
on the grounds of Article 8 of the European
Convention on Human Rights (ECHR); or
• Discretionary Leave as a result of a failed
asylum application; or
• Discretionary Leave where no application for
asylum has been made?
No
if ‘No’ go to a12
Yes – provide your:
Home
Oce reference number
Date latest status granted
Day Month Year
Date this status is due to expire
Day Month Year
now go to b3
11SFW/PN1F/2122/EN
Section 3 - residence
Continued
a12 Have you or your:
• husband, wife, civil partner; or
• parent(s) or step-parent
been granted Humanitarian
Protection?
No
if ‘No’ go to a13
Yes – provide
your:
Home Oce reference number
Date latest status granted
Day Month Year
Date this status is due to expire
Day Month Year
now go to b3
Have you lived outside the UK and Islands
since your latest status was granted?
No
go to section 4
Yes
if ‘Yes’ go to b3
a1
3
Have you been granted ‘leave to remain’ in
the UK under section 67 of the Immigration
Act 2016, or are you the dependant child of
someone who has?
No
if ‘No’ go to a14
Yes – provide your:
Home Oce
reference number
Date status granted
Day Month Year
Date this status is due to expire
Day Month Year
Have you lived outside the UK and Islands
since your latest status was granted?
No
go to section 4
Yes
if ‘Yes’ go to b3
12 SFW/PN1F/2122/EN
Section 3 - residence
Continued
a14
Have you been granted ‘Calais leave’ in
the UK, or are you the dependant child of
someone who has?
No
if ‘No’ go to a15
Yes – provide your:
Home Oce
reference number
Date latest status granted
Day Month Year
Date this status is due to expire
Day Month Year
Have you lived outside the UK and Islands
since your latest status was granted?
No
go to section 4
Yes
if ‘Yes’ go
to b3
a15
Ha ve you been granted ‘leave to
remain’ in t
he UK as a victim of
domestic violence or abuse, or are
you the dependant child of someone
who has?
No
if ‘No’ go to a16
Yes – provide your:
Home Oce reference number
Date status granted
Day Month Year
Date this status is due to expire
Day Month Year
now go to b3
a16
Have you been granted ‘leave to remain’ as
a person who has been a bereaved partner,
or are you the dependant child of someone
who has?
No
if ‘No’ see below
Yes – provide your:
Home Oce reference number
Date status granted
Day Month Year
Date this status is due to expire
Day Month Year
now go to b3
If you have answered ‘No’ to all questions check the notes for more information on what
to do next.
13SFW/PN1F/2122/EN
Section 3 - residence
Continued
b1 In the three years prior to the start of the rst
academic year of your course, did you live
outside the UK and Islands at any time?
No
Yes
now go to b2
b2 Give details of your residence for the three years before the start of the rst academic year
of your course. For example: if your course starts in September 2021, we need to know
where you lived between 01/09/2018 and 01/09/2021. If your course starts in March 2022,
we need to know where you lived between 01/01/2019 to 01/01/2022.
There should be no gaps in the dates you give us.
Full Address
From
Day Month Year
To
Day Month Year
Why were you there?
Full Address
From
Day Month Year
To
Day Month Year
Why were you there?
Full Address
From
Day Month Year
To
Day Month Year
Why were you there?
Full Address
From
Day Month Year
To
Day Month Year
Why were you there?
now go to b4
14 SFW/PN1F/2122/EN
Section 3 - residence
Continued
b3 Give details of your residency from the date you received your last status from the Home
Oce to the rst day of the rst academic year of your course. There should be no gaps in
the dates you give us.
Full Address
From
Day Month Year
To
Day Month Year
Why were you there?
Full Address
From
Day Month Year
To
Day Month Year
Why were you there?
Full Address
From
Day Month Year
To
Day Month Year
Why were you there?
Full Address
From
Day Month Year
To
Day Month Year
Why were you there?
now go to b4
15SFW/PN1F/2122/EN
Section 3 - residence
Continued
b4 At any time since 1 September 2018 has:
• either of your parents, step-parents,
guardians; or
• your husband, wife, civil partner
lived or worked outside the UK and Islands
or, in the case of an EU, EEA or Swiss
national, outside the EEA or Switzerland?
No
if ‘No’ go to section 4
Yes
if ‘Yes’ give details below
Full Address
From
Day Month Year
To
Day Month Year
Why were they there?
Full Address
From
Day Month Year
To
Day Month Year
Why were they there?
Full Address
From
Day Month Year
To
Day Month Year
Why were they there?
Full Address
From
Day Month Year
To
Day Month Year
Why were they there?
16 SFW/PN1F/2122/EN
!
Section 4 - about your course and your university or
college
a
In this section, please give details of your rst choice university or college and course.
University or college name and address
Postcode
UCAS personal identication number
UCAS university or college code
UCAS campus code (if applicable)
b1 Course name
If you are following a combined studies or modular course, please list all subjects being studied.
UCAS course code
ualication you expect to gain
(for example
BSc Physics)
Q
Course start date
Month Year
Course end date
Month Year
Course length (years)
b2 Year of course
Foundation - go to c
First year - go to c
Second year
Third year
Fourth year
Other (give details)
Are you a direct entrant?
Yes No
17SFW/PN1F/2122/EN
c Full tuition fee amount for this academic year
If the course is franchised to another university or college, give their address below.
Postcode
£
d Course type (please tick one box):
Full-time undergraduate
Full-time postgraduate Initial Teacher Education (ITE)
Full-time involving a placement (sandwich course)
Full-time foundation degree
Full-time distance learning
Did you start your course before 1 August 2018
and have a disability which prevents you from
attending your university/college
in person? Yes No
If ‘Yes’, you must provide evidence that clearly
shows you are unable to attend university or
college in person for a reason which relates to
your disability.
Section 4 - about your course and your university or
college
Continued
18 SFW/PN1F/2122/EN
Section 4 - about your course and your university or
college
Continued
Term details
e1 Where will you live during this academic year?
Term 1 Living with parent(s) Elsewhere or own home
Term 2 Living with parent(s) Elsewhere or own home
Term 3 Living with parent(s) Elsewhere or own home
e2 Where will you spend most of your
time this academic year?
Term 1 University or college Study abroad Work placement
Term 2 University or college Study abroad Work placement
Term 3 University or college Study abroad Work placement
if you have ticked ‘University or college’
for all 3 terms go to section 5
f Will you be undertaking a placement as part of the Turing
Scheme or the Erasmus+ programme?
Yes No
if ‘Yes’ and/or you’ll be studying abroad
go to section 5
19SFW/PN1F/2122/EN
g
Placement details
Where will your placement be?
Abroad
UK
Don’t know
Placement name and address
Postcode
Is the placement:
paid
unpaid
If ‘unpaid’, please tick which type:
a hospital, Public Health Service Laboratory or with a Clinical Commissioning group;
a Special Health Authority, the National Health Service Commissioning Board, the
National Institute for Health and Care Excellence, the Health and Social Care Information
Centre, Local Health Board, Health Board, Special Health Board or Health and Social
Services Board;
a Local Authority carrying out its duties relating to health, welfare or caring for children and
young people, a voluntary organisation providing facilities or carrying out similar activities
or a Local Authority acting in the exercise of public health functions;
the prison or probation sector or after-care services;
unpaid research in a UK or overseas institution; or
an unpaid placement that is not listed above.
Section 4 - about your course and your university or
college
Continued
20 SFW/PN1F/2122/EN
Section 5 - previous nancial support and other
information
Previous study
a1 Have you attended any full-time, ITE or sandwich courses of
Higher Education since you left school?
Yes No
a2 Have you been awarded an honours degree from a UK university?
Yes No
a3 If you answered ‘Yes’ to either a1 or a2, please give course details below.
Do not list A Level/AS Level examinations or equivalent.
Title of course
(for example, BA
History or BA
Honours History)
Full-time, Part-
time or Full-time
distance learning
Name of university
or college
Date you
started
Month/Year
Date you
left
Month/Year
Did you nish
this course?
Yes No
Yes No
Yes No
Yes No
If you did not nish any course listed above, why was this?
21SFW/PN1F/2122/EN
b Have you applied for nancial support for Higher Education before (for example, a grant or loan,
tuition fees or bursary including support for fees) from a Local Authority or any other organisation in
the UK (for example, Department of Health)?
Did you apply for support? (Tick ‘Yes’ even if you didn’t receive it)
Yes No
if ‘No’ go to c
Give details below.
Name of the Local
Authority or organisation
you applied to
What type of support
did you receive?
Period the
support covered
from to
Month/Year Month/Year
Month/Year Month/Year
Month/Year Month/Year
If any of the periods of support you have given above involved a period of suspended study
where you did not receive any support give the suspension date periods below and give the
reasons why you suspended study. For example, if you received support from 2006 to 2011
but between 2007 and 2008 you did not receive support because you suspended study that
year.
c In this academic year, are you eligible to apply for any bursary or award, excluding a social
work bursary from any of the following?
• National Health Service (NHS)
• Department of Health (DoH)
• Student Awards Agency Scotland (SAAS)
Yes No
If ‘Yes’, is this bursary or award
Income assessed
Non-income assessed
Section 5 - previous nancial support and other
information
Continued
22 SFW/PN1F/2122/EN
–
–
Section 6 - your UK bank or building society account
details
If you are only applying for a Tuition Fee Loan and/or a Fee Grant you do not need to
complete this section.
This account must be in your own name and be able to accept direct credits.
Please note that missing or incorrect bank or building society details will result in your
Maintenance Loan, bursary (if applicable) or any grant payments being delayed.
Sort code
Account number
Building society roll number
23SFW/PN1F/2122/EN
£
Loan request section
If you are applying for a Maintenance Loan, Tuition Fee Loan (or both) you should complete this
section to tell us how much you want to apply for.
National Insurance number:
We will share the National Insurance number you provide with the Department for Work and Pensions
to conrm that it’s valid, and with HM Revenue and Customs to allow us to collect your repayments.
Maintenance Loan
Amount of Maintenance Loan you would like to apply for:
Tick the box if you would like to apply for the maximum available to you
If you wish to apply for less than the maximum available to you, please state
the amount
Tuition Fee Loan
Make sure you nd out from your university or college how much they will be charging before
you apply for a Tuition Fee Loan. To nd out how much you can apply for visit:
www.studentnancewales.co.uk
Amount of Tuition Fee Loan you would like to apply for:
Tick the box if you would like to apply for the maximum available to you
If you wish to apply for less than the maximum available to you, please state
the amount
Contact details
Please give the names and addresses of two contacts. The contacts you give should live at
dierent addresses and will only be contacted if, for example, you move address and do not
inform us. You must inform your contacts that you are providing us with their details.
Contact 1
Forename(s)
Surname
Relationship to you
Address
Postcode
Country
Phone number
Contact 2
Forename(s)
Surname
Relationship to you
Address
Postcode
Country
Phone number
£
– –
24 SFW/PN1F/2122/EN
Section 7 - dependent and independent students
This section determines whether you are a dependent or an independent student. This
is important as it establishes whose income we need to take into account from your
household before we calculate your entitlement.
a1 Will you be aged 25 or over on the rst day of the
academic year?
Yes No
a2 Have you been married or in a civil partnership at
any time before the rst day of the academic year?
Yes No
a3 Will you have care of a person under the age of 18
on the rst day of the academic year?
Yes No
if you have ticked ‘Yes’
in any of any of the
boxes in question ‘a’
go to section 8. If you
have ticked ‘No’ go to
question ‘b’
b Please tick the relevant box if any of the following apply to you:
Your parents cannot be found or it is not reasonably practicable to get in touch with them
You are irreconcilably estranged from (have no contact with) your parents and this will
not change
If you start your course on or after 1 August 2018 - at any point from the age of
14 to the rst day of the rst academic year of the course, you have not been under
the legal care of your parents for 13 weeks or more, you have been under a special
guardianship order or you have been in the custody or legal care of, or have been given
accommodation by a Local Authority for 13 weeks or more
If you started your course before 1 August 2018 - at any point from the age of 16 to
the start of your course, you have not been under the legal care of your parents; and, for
three months or more, you have been in the custody or legal care of, or have been given
accommodation by, a Local Authority
Both your parents are deceased
You have applied for student nance before, and the parent who was assessed for a
contribution is deceased
Your parents are living outside the UK, Gibraltar or EU and the assessment of their
nancial circumstances would place them in jeopardy
Your parents are living outside the UK, Gibraltar or EU and it would not be reasonably
practicable or possible for them to send you money
If you have ticked any of the boxes above, you will be
contacted for evidence and, subject to this, you may be
considered independent.
if you have ticked any of
the boxes in question ‘b’
go to section 8
25SFW/PN1F/2122/EN
Section 7 - dependent and independent students
Continued
c Have you supported yourself nancially for a total of
three years or more prior to the start of the rst
academic year of your course?
Yes No
if ‘No’ you are a
dependent student.
go to section 8
If ‘Yes’, you may be considered an independent student. Give details below.
Name and address of
your employer or your
benet oce
Did you work
full or part-time?
From
Month/Year
To
Month/Year
Amount of salary,
wages or benet
you received (state
whether it was weekly,
monthly or yearly)
26 SFW/PN1F/2122/EN
£
£
£
Section 8 - student nancial details
If you leave any questions blank we will not be able to process your application. If a question
does not apply to you enter ‘None’ or ‘N/A’ as the answer.
a
Unearned income
Taxable unearned income is any income you receive from the following sources:
• Bank or building society gross interest
• Property, lettings or rent
• Dividends or investments
• Trusts or sponsorships
• Any other payment received for attending the course
Estimate the total taxable unearned income, before deductions,
that you expect to receive during this academic year.
What is the source of this income?
b
Payments from an employer
Will you be employed during the academic year 2021/22?
Yes No
if ‘No’ go to d
Will your employer be specically releasing you to attend
your course this academic year?
Yes No
if ‘No’ go to d
If ‘Yes’, how much will your employer pay you for time spent
attending your course during this period?
c During this academic year, will you or your employer
pay any money into a pension fund on your behalf?
Yes No
If ‘Yes’, how much during this period?
d
Dependent children
Give details of any children who will be wholly or mainly nancially dependent on you during
this academic year.
The child’s income includes their income from all sources after income tax and social security
contributions in tax year 2019-20. Do not include any income from Child Benet or Child
Tax Credits.
Child’s full name Date of birth
Relationship
to you
Who will they
live with?
Child’s income
in 2019-20
27SFW/PN1F/2122/EN
Section 9 - Special Support Grant
You may be eligible for a Special Support Grant instead of a Welsh Government
Learning Grant depending on your circumstances.
a To apply for a Special Support Grant tick the box(es) that are relevant to you.
You must send supporting evidence with your application.
I’m a lone parent (or a lone foster parent) with a child, or young person aged under 20
who is in full-time education below higher education level
I have a partner who is also a full-time student, and one or both of us are responsible
for a child, or young person aged
under 20 who is in full time education below higher
education level
I have a disability and qualify for the Disability Premium or Severe Disability Premium
I’m deaf and qualify for Disabled Students’ Allowance
I have been treated as incapable of work for a continuous period of at least 28 weeks
I have a disability and qualify for Income-Related Employment and Support Allowance
I’m waiting to go back to a course having taken agreed time out from that course due to
an illness or caring responsibility that has now ended
I’m aged 60 or over
I’m entitled to Housing Benet or the housing element of Universal Credit
I’m entitled to Personal Independence Payment (PIP)
I’m entitled to Disability Living Allowance (DLA)
I’m entitled to Armed Forces Independence Payment (AFIP)
None of the above
If none of the above apply to you, or you can’t provide the necessary evidence you won’t
be elig
ible for a Special Support
Grant. You’ll be assessed for a Welsh Government
Learning Grant instead.
28 SFW/PN1F/2122/EN
£
£
£
£
Section 10 - Parents’ Learning Allowance, Adult
Dependants’ Grant and Childcare Grant
You only need to complete this section if you are a student who has children
or adult dependants and you want to apply for nancial help in relation to them.
a Are you a lone parent?
Yes No
if ‘Yes’ go to d
b1 Are you under 25, living with a partner and applying for
a Childcare Grant or Parents’ Learning Allowance?
Yes No
if ‘No’ go to d
If you answer ‘Yes’ to b1 and you are a care leaver - go to c
b2 Did you start your course on or after 1 August 2018?
Yes No
if ‘Yes’ go to d
c Give the total estimated income after Income Tax and National Insurance deductions in this
academic year for:
You Your partner
How much of this will be Child Tax Credit or the child element of Universal Credit for this
academic year?
You Your partner
d
If you are not applying for Childcare Grant go to e1
During the academic year, do you or your partner
expect to receive:
• the childcare element of Working Tax Credit or Universal Credit; or
• Tax-Free Childcare from HM Revenue and Customs (HMRC); or
• Childcare Allowance from the NHS?
Yes No
If ‘Yes’, you can’t get Childcare Grant if you receive childcare support from one of these
sources at the same time. You can only apply for Childcare Grant if you stop claiming
support from any of the above sources.
You are not eligible for Adult Dependants’ Grant for:
• your other adult dependant if their income is more than £3,923 in the academic year 2021/22.
• your cohabiting partner if you started your course before 1 August 2018 and were under 25
on the 1st day of the 1st academic year of your course.
e1 Are you applying for Adult Dependants’ Grant?
Yes No
if ‘No’ go to f
e2 Who is your adult dependant?
husband
wife
civil partner or
partner
go to f
other adult dependant
29SFW/PN1F/2122/EN
£
£
£ £
£ £
£
£
Section 10 - Parents’ Learning Allowance, Adult
Dependants’ Grant and Childcare Grant
Continued
£
£
£
£
£
£
£
e3 Will your ‘other adult dependant’s’ income be
more than £3,923 in this academic year?
Yes No
if ‘Yes’ you will not receive
Adult Dependants’ Grant –
go to f
e4 Give your adult dependant’s income for the 2019-20 tax year.
Income
All salary, wages and self-employed income
(including income from property)
All income from pensions, including private,
occupational and state
If you receive a lump sum pension, only declare the
amount you received that you paid tax on.
All gross taxable income and interest from
savings, investments and dividends
Taxable state benets
All other taxable income
Deductions
Private pension contributions and Additional
Voluntary Contributions (AVCs)
Allowable expenses on which tax relief is
claimed
f Only complete this question if you started your course before 1 August 2018
Give details of nancial commitments you have before the start of your course which you,
your husband, wife or partner will continue to pay during the academic year.
Please enter the annual amount
Type
Type
Type Type
Type Type
Type Type
30 SFW/PN1F/2122/EN
Section 11 - about your family
If you are a dependent student, go to question a.
If you are an independent student with a partner, read and sign the Terms and
Conditions on pages 31 and 32 and then pass this form to your partner to complete
section 12.
If you are a single independent student, go to the Terms and Conditions on pages 31
and 32.
a Which parent do you normally live, or have more contact with?
Mother Father
b
What is the current relationship status of
this parent?
Single
Living with a partner
Married/civil partnership
Separated
Divorced/dissolved civil partnership
Widowed/surviving civil partner
or
Both N/A
What you need to do next
Read and sign the
Terms and
Conditions on
pages 31 and
32
and
then pass this form to your parent(s).
W
h
at y
our parent(s) need to
do next
The p
arent(s) you normally live with
should complete section 12.
If the parent indicated in ‘a’ is
married, in a civil partnership or living
with a partner, their partner must also
complete section 12.
31SFW/PN1F/2122/EN
Terms and Conditions
Terms and conditions
These terms and conditions (“terms”) and applicable
legislation apply to all of the student finance available to
students for the academic year 2021/22.
I understand that I must read the specific terms about
the student finance products available because they will
affect me if I apply for them at any time in this academic
year.
Loan Contract
1. I confirm I have read and understood these terms
and A Guide to Terms and Conditions available at
www.studentfinancewales.co.uk/terms-and-
conditions
2. I confirm that to the best of my knowledge and
belief, the information I have provided is true and
complete. If it is not, I understand that I may not
receive student finance, any support I have had
may be withdrawn and I could be prosecuted.
3. I understand that student finance is provided to
me by the Welsh Ministers (the “Lender”) which
includes any persons acting on their behalf and
any replacement(s) under section 23(4) of the
Teaching and Higher Education Act 1998 as
amended or replaced from time to time (the “Act”).
4. I understand these terms, the Act and the
regulations made under section 22 of the Act will
apply to any student finance provided to me by the
Lender.
5. I understand that “student finance” in these terms
means financial support by way of grant(s) and/or
loan(s) made by the Lender under the regulations.
6. I understand that the Student Loans Company
Limited (“SLC”) carries out certain functions on
behalf of the Lender.
My Obligations
7. I understand that if I have:
(i) reached the age of 18 years; and
(ii) have entered into agreement(s) for a loan
under section 22 of the Act before I reached
the age of 18 years,
I am agreeing to “ratify” any and all such student
loans by signing these terms. This means that I
confirm I entered into agreement(s) with the Lender
and agree to the terms of any such previous
agreement(s). If I have reached the age of 18
and refuse to “ratify” any previous agreement(s),
I understand that I will not be eligible to get any
further student finance under the regulations.
8. I agree to give SLC any information they need in
support of this application for student finance and/
or to seek repayment.
9. I agree to tell SLC immediately if my circumstances
change in any way that might affect my entitlement
to student finance. I understand that if I do not do
this I may not get any further payments and I may
have to repay the student finance I have already
received. I agree that from the date I submit
my student finance application until my loan(s),
together with all and any interest, penalties and
charges which apply, is fully repaid I must tell
SLC about any changes in my personal details
(including my National Insurance number) and
contact details I have provided.
10. I agree that if I get an overpayment of student
finance, I need to repay this in full and that any
overpayment may be taken from any future
entitlement to student finance.
11. I agree that I will repay the Lender any loan(s),
together with all and any interest, penalties
and charges which apply. I understand that
this repayment will be due by me to the Lender
as a debt. If I breach any of the terms of my
loan, I agree to pay any charges and penalties
which apply under the Act and the regulations. I
understand that I will repay my loan(s) through the
United Kingdom (“UK”) tax system and/or I may
repay SLC directly. If I live abroad, I will repay my
loan(s) to SLC directly.
12. I agree that any loan(s) made to me in accordance
with the regulations once my application is
accepted by the Lender is a/are contract(s)
between me and the Lender. I understand that I am
liable for my loan(s) and will be charged interest
from the first payment of the loan advance by the
Lender.
13. I agree to tell SLC if I leave the UK to live outside
the UK or if for any other reason I am outside the
UK tax system for more than three months.
Legal Action and Applicable Law
14. In the event of any legal action, I agree that the
laws of England and Wales will apply and that the
courts of that part of the UK will hear any legal
action. If my address is outside the UK the laws
of the part of the UK where my education provider
is situated will apply and the courts of that part of
the UK will hear any legal action. I agree that the
Lender has the right to take legal action against me
in any other court with jurisdiction.
Sharing Information
15. If I am in breach of these terms and/or the
regulations I agree that the Lender may share
information held about me and my account with
third parties, including the government or a
government agency of another country, who may
help to locate me and/or help take action to recover
any payments I owe.
16. I confirm where I have provided any personal
information about any other person in my
student finance application, I have done so with
their consent.
17. I understand that SLC will process my personal
data in line with the Privacy Notice available at
www.studentfinancewales.co.uk/privacy-notice
which may be updated from time to time.
32 SFW/PN1F/2122/EN
r
!
Disabled Students’ Allowance (“DSA”)
This section applies if I apply for DSA this academic
year.
18. I understand that any equipment I receive through
DSA must be used for my course of study and that
I am responsible for paying any repair costs.
19. I understand that if I consent to SLC sourcing my
equipment and support, SLC can pay the suppliers
of any approved equipment and support directly.
20. I understand that with my consent, SLC can make
payment to the needs assessment centre on my
behalf.
21. I understand that with my consent, SLC can make
a direct payment on my behalf to third parties
providing any other approved service or support to
me.
22. If I do not agree to SLC paying the suppliers of
equipment, support or other services on my behalf,
I understand that I will be responsible for meeting
the costs of any approved equipment, support
or other services out of my DSA allowance. SLC
reserves the right to request evidence of receipt of
equipment, support or other services in relation to
my DSA.
Childcare Grant (“CCG”)
This section applies if I apply for CCG this academic
year.
23. I understand that if I do not provide the evidence
of childcare costs within the timescales set, I may
lose my entitlement. If my childcare costs are
different from the estimates I have provided, further
payments of my CCG may increase or decrease
accordingly. If no further CCG payments are due
to be paid to me, I may be liable to repay any
difference.
24. I understand that if I do not take up my childcare,
or if I change to a childcare provider who is not
registered or approved, I will have to pay back any
overpayment.
25. I confirm that neither I nor my husband, wife,
civil partner or cohabiting partner have chosen to
receive support for childcare from:
(i) the childcare element of Working Tax Credit;
(ii) the childcare element of Universal Credit;
(iii) Tax-Free Childcare; and/or
(iv) the NHS Bursary Childcare Allowance;
and I agree to tell SLC immediately if I or my
husband, wife, civil partner or cohabiting partner
does receive this support. I understand that SLC
may share my personal data with HMRC to check
whether I get childcare support.
Customer Reference Number
Your full name
(in BLOCK CAPITALS)
Your signature
Today’s
date
Day Month Year
The relevant person(s) you indicated in section 11 must complete section 12 as well as
the declaration(s) on page 41.
Please pass this form to them now.
If you are a single independent student, please turn to page 42 to nalise your
application.
33SFW/PN1F/2122/EN
Section 12 - nancial details for tax year 2019-20
for parents and partners
Who needs to complete this section?
Section 11 of this form tells you who needs to complete this section.
What details do I need to provide in this section?
You need to tell us some personal details and what your nancial income was for tax year
2019-20. You must tell us your 2019-20 income details as we cannot accept amounts from
any other tax year. We need your income amounts so we can work out what the student(s)
you are supporting is entitled to.
About this section
Section 12 is split into six parts:
Part A - Tell us your name and address and some other personal information.
Part B - Tell us your National Insurance number.
Parts C and D - Answer every question.
Part E - Answer every question and tell us about any income deductions for tax year
2019-20 where appropriate.
Part F -
Tell us about any
children who are nancially dependent
on you.
How to complete this section
If you are a single parent of the student
Enter your information as Person 1, leave Person 2 blank.
If there are two parents in the student’s household
Complete this section with information for both Person 1 and Person 2.
If you are the partner of an independent student
Enter your information as Person 1, leave Person 2 blank.
If you’re self assessed – read page 26 of the notes for more information.
If you’re not self assessed – you can use your P60 to complete this section.
What happens if my household income has dropped since tax year
2019-20?
If your household income has dropped by 15% or more since tax year 2019-20 you can apply for a
‘Current Year Income Assessment’.
This means we would use your expected income for tax year 2021-22 instead of your actual income
from tax year 2019-20 when calculating the student’s entitlement. However, there must be at least a
15% drop in the overall household income (not just your own income) between these two tax years
for us to do this and we will ask for evidence of your 2021-22 income at the end of that tax year.
Before completing this form, you should read the Privacy Notice on page 34 of the accompanying notes.
The student may be eligible for a bursary or scholarship. In order for a university or college to determine
and pay any bursary or scholarship to which the student(s) you are supporting may be entitled, we will
share some of your personal and nancial details with them. For more information about this, read our
Privacy Notice.
34 SFW/PN1F/2122/EN
Section 12 - nancial details for tax year 2019-20
for parents and partners
Continued
/
/
/
/
Part A – Your personal details
Person 1
Your Customer Reference Number
(If you have one)
Relationship to the student
Title
Forename(s)
Surname
Any previous names you may be known by
Date of birth
Place of birth
(name of town or village exactly as it appears
on your birth certicate or passport)
Home address
Postcode
Home telephone number
Email address
Preferred correspondence language
Welsh English
Person 2
Your Customer Reference Number
(If you have one)
Relationship to the student
Title
Forename(s)
Surname
Any previous names you may be known by
Date of birth
Place of birth
(name of town or village exactly as it appears
on your birth certicate or passport)
Home address
Postcode
Home telephone number
Email address
Preferred correspondence language
Welsh English
You do not have to disclose your nancial information to the student.
If you would like to provide it separately, you can download an Assessment of Financial Circumstances
form (PFF2) 2021/22 from: www.studentnancewales.co.uk and return it to us.
Alternatively, you can have the form sent to you by ticking this box:
Person 1
Send me a separate form
Person 2
Send me a separate form
35SFW/PN1F/2122/EN
Section 12 - nancial details for tax year 2019-20
for parents and partners
Continued
-
-
-
-
Part B – Data sharing and you
We will share and check the details you give us with HM Revenue & Customs, allowing
us to gain the most accurate information possible. This can only be done if you have a
valid National Insurance (NI) number.
Person 1
I have an NI number
Please provide your NI number below:
Person 1
You are now ready to provide
your nancial information.
go to Part C
I do not have an NI number
If you do not have an NI number
because you receive non-UK
taxable income, please provide the
equivalent nancial information in
pounds sterling.
You are now ready to provide
your nancial information.
go to Part C
Person 2
I have an NI number
Please provide your NI number below:
Person 2
You are now ready to provide
your nancial information.
go to Part C
I do not have an NI number
If you do not have an NI number
because you receive non-UK
taxable income, please provide the
equivalent nancial information in
pounds sterling.
You are now ready to provide
your nancial information.
go to Part C
36 SFW/PN1F/2122/EN
!
£
£
£
£
£
£
£
£
Section 12 - nancial details for tax year 2019-20
for parents and partners
Continued
Part C – Your nancial information for the tax year 2019-20
Instructions
• Please give nancial details for tax year from 6 April 2019 to 5 April 2020.
• Answer ‘Yes’ or ‘No’ to every question, if you answer ‘Yes’ please provide the income amount.
• If any questions are left blank we will not be able to process this application.
You do not need to send us any evidence. However, you should keep all of
your 2019-20 nancial evidence as we may ask for it at a later date to verify the
details you have provided.
Q1 Did you receive any income from salary, wages,
taxable state benets or from occupational or private
pensions?
Person 1
Yes No
Person 2
Yes No
a Total income from salary / wages
b
Total income from taxable state benets
c
Total income from occupational pension(s)
If you receive a lump sum pension, only declare the amount you
received that you paid tax on.
d Total income from private pension(s)
If you receive a lump sum pension, only declare the amount you
received that you paid tax on.
37SFW/PN1F/2122/EN
£
£
£
£
£
£
£
£
£
£
£
£
£
£
Section 12 - nancial details for tax year 2019-20
for parents and partners
Continued
Q2 Did you receive any income from a state retirement
pension?
Person 1
Yes No
Person 2
Yes No
a Total non-lump sum amount received
b Total lump sum amount received
Q3 Did you receive any income from savings and
investments?
Person 1
Yes No
Person 2
Yes No
a Total interest from UK banks, building societies and
unit trusts
b Total income from UK life insurance gains, securities
and partnerships
c Total income from UK investments and dividends
d Total income from foreign investment and dividends
Q4 Did you receive any taxable benets in kind?
Person 1
Yes No
Person 2
Yes No
(for example a company car or private medical
insurance)
Total income received from taxable benets in kind
Q5 Did you receive any other income during the 2019-20 tax year that you haven’t yet told us about?
Person 1
Yes Go to Part D
No Go to Part E
Person 2
Yes Go to Part D
No Go to Part E
38 SFW/PN1F/2122/EN
Part D – Other income
Instructions
• Complete Part D in the same way you completed Part C giving nancial details for the tax year
from 6 April 2019 to 5 April 2020.
Q1 Did you receive any income from self-employment?
Person 1
Yes No
Person 2
Yes No
a Total adjusted prot from businesses
b Total adjusted prot from partnerships
£
£
£
£
Q2 Did you receive any income as a Minister of religion?
Yes No
Yes No
Total taxable income minus expenses that are not
included on your P60 or P11D.
Q3 Did you receive any other taxable income or lump
sums?
Yes No
Yes No
Total income received
Q4 Did you receive any income from property lettings?
Yes No
Yes No
Total income received
Q5 Did you receive any income from UK trusts?
£
£
£
£
£
£
Yes No
Yes No
Total income received
£
£
Section 12 - nancial details for tax year 2019-20
for parents and partners
Continued
39SFW/PN1F/2122/EN
£
£
£
£
£
£
£
£
£
£
£
£
Section 12 - nancial details for tax year 2019-20
for parents and partners
Continued
Q6 Did you receive any foreign income?
Person 1
Yes No
Person 2
Yes No
Total income received
Q7 Did you receive any income from an overseas
pension?
Yes No
Yes No
Total income received
Q8 Did you receive any other overseas income
and gains?
Yes No
Yes No
Total income received
Part E – Income deductions
Instructions
• Complete Part E in the same way you completed Part D giving nancial details for the tax year
from 6 April 2019 to 5 April 2020.
Q1 Did you pay any private pension contributions?
Person 1
Yes
No
Person 2
Yes No
Total amount you paid
Q2 Did you pay any Additional Voluntary Contributions
(AVCs)?
Person 1
Yes
No
Person 2
Yes No
Total amount you paid
Q3 Did you have any allowable expenses on which
you claimed tax relief?
Person 1
Yes No
Person 2
Yes No
Total amount on which you claimed tax relief
40 SFW/PN1F/2122/EN
Section 12 - nancial details for tax year 2019-20
for parents and partners
Continued
Part F – Your dependants
Identify any children who will be wholly or mainly nancially dependent on you.
Q1 Child dependants not in further or higher education in academic year 2021/22
Include unearned income for all dependants. Only include earned income details for persons
aged 16 and over. Do not count casual earnings of persons under 16.
Full name
Date of birth
(DD MM YYYY)
Income for the year
Q2 Child dependants in further or higher education in academic year 2021/22
Do not include the applicant when completing this question.
If the student is your partner, please include any children they named in section 8 of this form if
the children have applied for student nance.
Full name
Date of birth
(DD MM YYYY)
School, college or
university
Course
Are they receiving
nancial support?
If so, from which
authority or
organisation?
41SFW/PN1F/2122/EN
Declaration for parents and partners
Before signing, you should read the Privacy Notice in the notes that accompany this form.
This application for nancial support may be delayed unless you sign and date this declaration.
• I conrm that to the best of my knowledge and belief, the information I have provided
is true and complete. If it is not I understand I might be prosecuted and nancial
support withdrawn. Any information provided which is found to be materially inaccurate
may be regarded as evidence of an attempt to mislead SLC. In such circumstances,
SLC may report the matter to the authorities and/or terminate the student’s eligibility for
student nance.
• I agree to supply any further information in relation to the applicant’s application
for nancial support that SLC may ask for and agree to tell them immediately if my
circumstances change in any way that might aect this application for nancial support.
Person 1
Your full name (in BLOCK CAPITALS)
Your signature
Today’s date
Day Month Year
Person 2
Your full name (in BLOCK CAPITALS)
Your signature
r
Today’s date
r
Day Month Year
Deadline
To make sure the student receives their rst payment at the start of term, this form must be
returned with all of the evidence we need by 4 June 2021.
We will do our best to process the application as soon as possible, however if the deadline
date has passed, the rst payment may not be ready for the start of term.
Now pass this form back to the student.
42 SFW/PN1F/2122/EN
Voluntary questions
The following questions are voluntary – you do not have to answer them. Whether or not you
answer will not aect our assessment of your entitlement to nancial support. If you answer
both questions a and b, the information will be used to help the Welsh Ministers develop their
policies in the future.
a Your parents’ education (this includes your natural parents, your adoptive parents, your
step-parents, partners of your parents, and your guardians).
Do any of your parents (as dened above) have any higher education qualications, for
example degrees and diplomas or certicates of higher education?
Yes No
b How would you describe your ethnic origin?
White:
British (Welsh) British (English)
British (Scottish) British (Other)
Irish Any other white background
Black or Black British:
African Caribbean
Any other black background
Mixed:
White and black African White and black Caribbean
White and Asian Any other mixed background
Chinese or other ethnic group:
Chinese Any other
Asian or Asian British:
Indian Pakistani
Bangladeshi
Any other asian background
43SFW/PN1F/2122/EN
Additional notes
If you are providing extra information please clearly mark what section and question the
information is about.
44 SFW/PN1F/2122/EN
Checklist
Before returning this form, please make sure you have done the following:
Fully answered all questions that apply to you.
Enclosed all evidence items.
Completed the Loan Request section if you are applying for a
Maintenance Loan, Tuition Fee Loan or both.
Signed and dated the relevant Terms and Conditions.
Asked your parent(s) or partner to complete section 12 if you are
applying for student nance based on your household income.
What happens next
It can take at least 6 weeks to assess your application and all the relevant evidence. We’ll
then send you a letter showing the amount of nancial support you’ll receive.
Please remember to pay the correct postage.
You must return your form to:
Student Finance Wales
PO Box 211
Llandudno Junction
LL30 9FU
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PN1 202122 New Student Application for Student Finance (London Institute of Management and Technology)

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Completed 14 June 2021

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