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INTERNATIONAL SUMMER MUSIC ACADEMY BURSARY APPLICATION FORM 2013 ALL APPLICANTS FOR FINANCIAL ASSISTANCE MUST COMPLETE THIS FORM IN ITS ENTIRETY. UNANSWERED PORTIONS AND/OR ABSENCE OF PROPER SIGNATURES WILL CONSTITUTE AN INCOMPLETE APPLICATION AND WILL DISQUALIFY THE APPLICANT FROM CONSIDERATION. INFORMATION WILL BE HELD IN STRICT CONFIDENCE.

APPLICANT’S INFORMATION FIRST NAME(S) _________________________________________________ LAST NAME: _________________________________________________ POSTCODE/ZIP CODE___________________________________________ NATIONALITY________________________________________________ PRINCIPAL INSTRUMENT_________________________________________ SECONDARY INSTRUMENT(S)__________________________________ ENSEMBLE NAME (if applying as pre-formed group) _________________________________________________

FINANCIAL ASSISTANCE PLEASE TICK CURRENT EDUCATIONAL LEVEL School

Undergraduate

Postgraduate

Young professional

Are you the recipient of any educational funds (family support, scholarship, grant award, or prize) from a country, organisation or individual specifically for your current course of educational study? Yes

No

If ‘Yes’ please give details (including those pending). Awarding body

Amount awarded

Date awarded/ Expected date of answer

Purpose of grant & dates covered

Have you applied for or received any educational funds (family support, scholarship, grant award, or prize) which can contribute towards your attendance at Lake District Summer Music during 2013? Yes

No

If ‘Yes’ please give details (including those pending). Awarding body

Amount awarded

Date awarded/ Expected date of answer

Purpose of grant & dates covered

How much financial aid towards fees would you need to come to Lake District Summer Music? Please be aware we may not award the full amount you ask for. £______________________________


YOUR CURRENT FINANCES Please answer the following questions in relation to the 12 months from September 2011 to August 2012

Income

£

Earnings from: Performances Teaching Other employment (list below)

Expenditure

£

Travel Food & accommodation Entertainment Education Fees: Education institution Private lessons/consultations

Scholarships Other special awards (e.g. grants)

Instrument (including bow if applicable) Purchase Hire Repairs

Competitions Prizes Other (please list)

Income Tax Other (please list)

TOTAL (income)

Assets Cash in hand or at bank Instrument insurance value Other (please list)

TOTAL (expenditure)

£

Liabilities Local Education Authority: The Student Loans Company: College or University: Bank: Credit Card: Other (please specify)

£


FINANCIAL INDEPENDENCE 1. Are you over 21 years of age?

Yes

No

2. Are you a post-graduate student? Yes

No

3. Are you supporting any dependents (i.e. children, elderly parent)?

Yes

No

 If you have answered ‘Yes’ to one or more of the above questions, you may claim yourself financially independent.  If you have answered ‘No’ to all the above questions answer questions 4 & 5.

4. Did you live in your parents’ home for six consecutive weeks in the past year?

Yes

No

5. Have you received more than £2,000 assistance from your parents in the past year? (Including clothing, medical care, insurance etc.) Yes

No

 If you have answered ‘No’ to both questions 4 & 5, above, then you may claim yourself financially independent.  If you have answered ‘Yes’ to one or more of the above questions, you must ask your parents to submit the required financial data below.

IF NOT FINANCIALLY INDEPENDENT PLEASE ASK YOUR PARENTS/GUARDIAN TO COMPLETE THE FOLLOWING: 2011/2012 Fiscal Year Gross Income Other Information Father / Guardian

EMPLOYER: POSITION: CONTACT TELEPHONE No: EMPLOYER: POSITION: CONTACT TELEPHONE No:

Mother / Guardian

Father/Guardian’s signature: _________________________________________________ Date:___________________ Mother/Guardian’s signature:_________________________________________________ Date:___________________ ALL STUDENTS

MUST PROVIDE AN INDEPENDENT FINANCIAL REFEREE (not a relative. This could be principal/head, bursar,

instrumental teacher, other funding body)

NAME:____________________________________________________

_

ADDRESS: ____________________________________________________ __________________________________________________________________________________________________________________ CONTACT TELEPHONE NUMBER:____________________________________________ EMAIL:_________________________________________________________ RELATIONSHIP OF REFEREE TO YOU:____________________________________________________________________________

ALL STUDENTS

MUST SIGN THIS DOCUMENT:

APPLICANT’S SIGNATURE: ________________________________________________________ Date:___________________

I understand that this application cannot be considered until the application form, deposit, passport-size photograph, CV and additional information have been submitted. Additional Information may be attached on a separate sheet which must be stapled to this form

isma_bursary_application_form_2013  
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