Student Bursary Application Form
PERSONAL DETAILS
TITLE INITIALS
FIRST NAME/S
SURNAME
PREFERRED NAME/S
SPECIFY ANY DISABILITY
RACE (FOR EQUITY PURPOSES) GENDER
FEMALE
MALE
ID NUMBER
DATE
OF
BIRTH
- -
D D M M Y Y Y
Y
RESIDENTIAL ADDRESS
POSTAL CODE
POSTAL ADDRESS
POSTAL CODE
CELLPHONE NUMBER -
TELEPHONE
(HOME)
-
E-MAIL ADDRESS
FAMILY INFORMATION
NUMBER OF SIBLINGS
PARENT INFORMATION
FATHER’S FIRST NAME/S
FATHER’S SURNAME
FATHERS OCCUPATION
CELLPHONE NUMBER -
TELEPHONE
(HOME)
-
MOTHER’S FIRST NAME/S
MOTHER’S SURNAME
MOTHER’S OCCUPATION
CELLPHONE NUMBER -
TELEPHONE
(HOME)
-
RESIDENTIAL ADDRESS
POSTAL CODE
HR1234
2017/01
Page 1 of 3
GUARDIAN INFORMATION
GUARDIAN’S FIRST NAME/S
GUARDIAN’S SURNAME
GUARDIANS OCCUPATION
CELLPHONE NUMBER -
TELEPHONE
(HOME)
-
RESIDENTIAL ADDRESS
POSTAL CODE
SECONDARY EDUCATION DETAILS
Please provide us with details of the last school(s) that you attended, including a list of the most recent subjects studied, as well as the grades and
symbols that you achieved. Applicant must have obtained at least 70% average on all subjects and Mathematics (not Mathematical Literacy) must
be inclusive of the subjects done. Please attach a certified copy of your latest results.
NAME OF SCHOOL
YEAR MATRICULATED
Subjects Grade Symbol
%
%
%
%
%
%
%
TERTIARY EDUCATION DETAILS
YEAR OF STUDY
UNIVERSITY/COLLEGE NAME
QUALIFICATION (BA, BCOM ETC)
CURRENT LEVEL OF STUDY
Subjects Symbol
HR1234
2017/01
Page 2 of 3
OTHER INFORMATION
What is your biggest achievement?
What differentiates you from your peers?
Why should STANLIB offer you this opportunity and describe your career goals?
DECLARATION
I hereby declare that the above information is true and correct and acknowledge that misrepresentations made by me will prejudice my application
with STANLIB. I also understand, that should my application be successful, standard recruitment checks are required by STANLIB.
SIGNATURE OF APPLICANT
DATE - -
D D M M Y Y Y Y
SIGNED AT
FOR OFFICE USE
DATE PROCESSED - -
D D M M Y Y Y Y
PROCESSED BY
APPLICATION SUCCESSFUL?
YES
NO
HR1234
2017/01
Page 3 of 3
STANLIB 17 Melrose Boulevard, Melrose Arch, 2196 P O Box 202, Melrose Arch, 2076
Email to: bursary@stanlib.com / Fax to: 0867 277 501 or 011 448 6666