MONASH SOUTH AFRICA BURSARY APPLICATION FORM

Application requirements
The Monash South Africa bursary process occurs twice a year in November and May. Successful applicants
will be notified respectively in December and June.

The closing date for applications is as follows:

Semester One Intake : 15 November

Semester Two Intake : 30 April

Note: No late applications or supporting documentation will be accepted.

To apply you need to:

Complete the application form;
Sign the declaration;
Attach all relevant supporting documentation as speci ed; and
Return to the Student Fees Officer by the closing date

By post: In person:
Student Fees Officer Student Services Centre
Student Administration Centre Monash South Africa
Private Bag X60 144 Peter Road
Roodepoort Ruimsig, Roodepoort
South Africa South Africa
1725 1725

Eligibility and supporting documentation

MonashSouth Africa bursaries are available to South African students who can provide supporting
documentation detailing extreme nancial hardship.

What does extre ial hardship mean?

An electronic means test is used to determine extreme financial hardship, factoring in other equity factors,
and rank each application.

Eligibility criteria:
To be eligible for a Monash South Africa bursary you must:

I. be enrolledor have received an o er to enrolas a full-time student at Monash South Africa in a

foundation programme or an undergraduate course of study leading to a higher education award;
II. not be a recipient of any other financial support award;
III. be studying Year 12 or equivalent (South African citizens) or be studying in the nal year of secondary
school or equivalent (international); or
IV. be a current Monash South African student and have completed a minimum of one semester of study
at Monash South Africa
V. Demonstrate nancial hardship.

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Supporting documentation:
If both parents are working, recent payslips not older than 2 months are required from each parent. If a
parent is paid on a weekly basis four consecutive payslips should be submitted. If a parent is paid on a
two-weekly basis (fortnightly) 2 consecutive payslips should be submitted.
If a parent is unemployed an affidavit signed by the unemployed parent is required, confirming
his/her own unemployment.
If a parent is working in the informal sector where official payslips are not issued (eg street vending or
informal selling) the rand value of the income gained per month must be stated in the affidavit.
If a parent is employed as a domestic worker, a letter from his/her employer is required, stating the
period of employment and the monthly salary.
If there is anybody in the household that receives a state pension or a child support grant, proof is
needed. A certified copy of the most recent pension slip, pay point slip or an original 3 month bank
statement should be submitted.
If the family/student is sponsored an affidavit signed by the sponsor should be submitted stated the
monthly rand value of the sponsorship.
If parents are divorced a certified copy of the divorce decree should be submitted.
If a parent is deceased, a certified copy of the death certificate should be submitted.
If the whereabouts of a parent is unknown or if the parent has absconded or does not contribute
towards the finances of the family, an affidavit is required from the parent whom the student lives with.
The parent writing the affidavit should not only indicate that he/she is single, but also that the other
parent’s whereabouts are unknown and that no financial support is received.
If a student lives with his/her grandparents, or guardian an affidavit from the guardian or grandparents is
required, stating the whereabouts of the biological parents and the rand value of the parents’ monthly
support to the student. If R0 it should be stated. Proof of income of grandparents should then also be
provided. Guardians should also provide an affidavit stating the monthly contribution to the student.
If a sibling (brother or sister) over the age of 18 is unemployed and is still living with the family an
affidavit signed by the unemployed sibling is required, confirming his/her own unemployment. If the
sibling is employed, recent payslips (not older than 2 months) is required.
If a sibling is studying a tertiary institution (university) a proof of registration of that particular student is
required.
Certified copies of identity documents (or birth certificates where identity documents are not available)
for the every member of the household including the applicant should be submitted.
If a student’s surname differs from his/her parent surname, an affidavit from one of the parent’s must be
submitted as to why the surnames differ.
Please note that no faxed copies of documents will be accepted. Documents may not be sent via
e-mail.
All copies of documents must be certified.
Please make sure all required documentation is attached before submitting the application form, a
incomplete applications will not be processed and it will be regarded asunsuccessful application.

Note: If you do not supply all required supporting documentation you application will be rejected
immediately.

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Section A: Applicants personal details
To be completed by students currently studying at Monash South Africa
Monash SA student number:
Surname:
First names:
South African ID number:
Study address:

Postal Code0000
Home address (where your family
currently lives):

Postal Code0000
Telephone (Home):
Telephone (Cell):
E-mail address:

Section B: Parent/Guardian Details

Surname:
First names:
South African ID number:
Married Single Divorced Widow/er
Occupation (Guardian):
Telephone (Cell):
E-mail address:
Occupation (Father):
Telephone (Cell):
E-mail address:
Occupation (Mother):
Telephone (Cell):
E-mail address:

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Section C: Course Details
Course Title:
Course Code:
Level of study (mark appropriate block): In the next semester/year I will be a……
1st time student You will be a 1st time student at MSA
Senior student You are continuing your studies in the same course as pervious
semester/year
Final Year student You will write your final examinations to graduate during the
following semester/year
Foundation to You will be completing your Monash South Africa Foundation
undergraduate degree programme and continuing with an under graduate degree
student during the following semester/year
Post Graduate student You will be registered for a Honours or higher qualification
during the following semester/year

Section D: Financial Status

Name of guardian:
Relation to applicant:
South African ID number:
Employer:
Position:
Gross annual income:
Name of father:
South African ID number:
Employer:
Position:
Gross annual income:
Name of mother:
South African ID number:
Employer:
Position:
Gross annual income:
Self sponsored:
Declare part-time income:

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Section E: Dependants of personal responsible for payment of fees
Please include yourself. If you include students (other than yourself) you must submit proof that they are
registered at a particular tertiary institution (proof of registration/acceptance). Persons over 18 that are not
employed should submit an affidavit stating that they are unemployed. If a dependent is working, the amount
contributed to the family income should be stated in an affidavit.
Name Age SA ID number Present activities Relation to
eg. Scholar/ student eg. sister
University student/
unemployed

Section F: Other equity factors to be taken into consideration

Category Tick if Supporting documentation
Applicable to
your
application
Recent Refugee 1. A description of your
For students that have had to leave or abandon circumstances and living conditions
their native country due to persecution or fear of
prior to leaving your country
persecution on account of race, religion, personal
associations, or political opinion. 2. Details of your education
completed prior to arriving in South
Africa and any education you have
completed in South Africa
3. Details of your travel method and
route to South Africa (specifically
how long it took between leaving
your country and arriving in South
Africa).

Difficult circumstances

a) abusive family environment 1. A statement describing the nature

of your difficult circumstances and
b) carer responsibilities (e.g. ill children, the effect this has had on your
parent, siblings) educational performance – this will
provide the assessor the

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Section F: Other equity factors to be taken into consideration
c) chronic medical condition of a dependent information they need to
child understand the effect of the
disadvantage.
2. A confidential statement of support
d) death of a parent/guardian
form downloaded and completed
as detailed in the form by a
e) homelessness relevant responsible person,
unrelated to you, who can verify
f) major illness of parent/guardian your circumstance/s.

g) multiple relocations/moving house A responsible person can be a:

h) natural disaster (e.g. bushfire, flood) Doctor or health care

professional
i) parent's separation/divorce Lawyer
Social worker
j) victim of crime. Registered counselor
Religious or community leader
School principal/teacher/senior
member of school staff.

Disability or long-term medical condition 1. An impact statement describing

This category applies if you have a disability or your disability or medical condition
medical condition that has affected your ability to
and demonstrating the effect on
study. This may include chronic pain, major
illness, drug addiction, learning disabilities and your educational performance. This
mental illness, eating disorder, glandular fever, statement provides the person
chronic fatigue syndrome or vision or hearing assessing your application the
impairments. information they need to
understand the effect of the
disadvantage.
2. You must also submit a confidential
statement of support form
completed by a relevant health
care professional (unrelated to you)
who is currently treating you and
can verify your circumstance/s.

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Section G: Applicants declaration
I hereby certify that the information provided on this form is correct and that I read and understand all
Monash South Africa rules and regulations. I also understand all the notes as set out on the following
pages. By handing in this form I take responsibility for the information provided.
I hereby authorize Monash South Africa to forward any personal information as well as any information
that I have provided in support of my application to verification information suppliers acting on behalf
of Monash South Africa for the purpose of verifying my personal credentials and records. Authorized
credential verification types include, but are not limited to, educational qualifications, professional
membership, employment history, employment references,consumer credit, criminal record and
fraud prevention checks.
I authorize Monash South Africa and/or its verification information suppliers to furnish information
regarding my credentials, whether claimed or not to Monash South Africa. I unconditionally indemnify
Monash South Africa and its verification information suppliers against any liability that may result from
furnishing information in this regard.

Applicants Signature: ……………………………………………………. Date: ……………………………

Parent/Guardian Signature: …………………………………………….. Date: …………………………….