Tel: +27 (0)10 206 0049

Website: www.ssp.org.za • Email: [email protected]

SSP SCHOLARSHIP APPLICATION FORM CLOSING DATE: 31 August 2015

1. GENERAL REQUIREMENTS
Scholars who meet the following criteria may apply:

 Currently in grade six (2015)

 12 years or younger in 2015
 Attaining an aggregate of 70% or above in their latest report
 Attaining 70% or above for Math, Natural Sciences and English
 Demonstrate financial need. Household income not exceeding R16 000 per month.

2. APPLICATION PROCEDURE

2.1 Complete the attached SSP application form (SECTION A, B, C and D) to be considered.

2.2 Attach copies of the following items to the completed form:

a) The applicant’s latest term report card – Grade 6 March 2015 as well as Grade 5 December 2014 School
reports
b) Copies of the following items:
o The child’s birth certificate
o Copies of parent’(s) Identity Document (ID)
 Where applicable - Parent (s)Death certificate/s
 Where applicable - Proof of adoption
If employed:
o Please attach latest pay slip
o Please attach latest three months bank statements
If unemployed
o Affidavit from the police station verifying unemployment
o Please attach latest three months bank statements
o Where applicable - Evidence that you receive government grants
If self-employed
o Please provide latest company three months bank statements and cash-flow statements

c) Please attach a credit report from Transunion; call 0861482482 for a free credit report and have a receiving
fax number or email address handy.

IMPORTANT NOTICE TO PARENTS /GUARDIANS/CAREGIVERS

 Submitting an application form does not guarantee the awarding of the scholarship. Applicants need to qualify
and complete the selection process before being considered for the scholarship. The decision to award the
scholarship rests solely with the Student Sponsorship Programme.
 Incomplete applications and applications that do not meet the SSP criteria will be rejected. In these cases, no
correspondence will be entered into. Only qualifying applicants will be contacted.
 Non South African citizens attending South African schools need to have valid refugee status documents in
order to apply.
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3. THE APPLICATION FORM

3.1 SECTION A Scholar Information

Please complete this section fully. It is important to fill in all details. The demographic questions and details about
the applicant’s current school asked in this section are for identification, research and statistical purposes.

3.2 SECTION B Parent/Caregiver/Guardian Information

This section is included to establish a primary contact person and to identify all primary caregivers of the scholar in
question. All people who fit into the following categories are considered primary caregivers and must be listed in this
section:

 All parents
 All people who act in the place of a parent and who live with the scholar most of the time.
 All people who act in the place of a parent, who do not live with the scholar, but who share full financial
responsibility of the scholar.

The name and contact details of the parent/caregiver/guardian’s spouse or partner must also be included. The
details of the parent/caregiver/guardian’s employment and the number of people in any one household are
important for statistical purposes and to assist us in determining the financial need of any particular family.

The gross monthly income received by each parent/caregiver/guardian must be declared. Any income from other
sources, not stipulated on a payslip must also be declared in the “Other income” section. This includes, but is not
limited to the following: child support grant, pension grant, disability grant, child maintenance, life or other
insurance moneys, income received from government tender processes, income from self-employment/private
business, income from informal trading and any commission earned over and above regular income. Any adults who
live with the scholar and are caregivers of the scholar, but do not contribute directly to the scholar’s living costs,
must still be included as a primary caregiver if they contribute in other ways to the household.

All expenditure within the scholar’s household must also be recorded. This includes all monthly expenditure such as
rental/bond payments, car instalments, groceries, school fees, transport, clothing and other accounts, etc. Please
tick all relevant items included in your monthly expenditure.

IMPORTANT NOTICE:
If awarded the SSP Scholarship, the successful candidates will be required to attend school at SSP selected partner
school. Tuition, and a small stipend to cover books, uniforms and stationery, will be payable by SSP. Parents will be
responsible for transport to school and daily meals.

Completed application forms (pages 3 – 5) should be emailed to [email protected] OR faxed to +27 86 680
2307 on or before 31 August 2015 with all the necessary documentation in 2.2 (noted above).

Interviews and entrance examinations will be held for qualifying shortlisted candidates during the course of
September to November 2015. The sole right of selection lies with the Student Sponsorship Programme.
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SCHOLARSHIP APPLICATION FORM – EAST LONDON

SECTION A
Scholar Information – to be completed by the scholar/applicant

Surname: _______________________________First Names:__________________________________________

Gender: F M Nationality:_______________________ Birth Date: / /
Day Month Year

Email: ______________________________________________________________________________________

Contact No.: (h)____________________________________(cell)______________________________________

Permanent Physical Address:___________________________________________________________________

Current School Name:_________________________________________________________________________

Current Grade:___________________________ Principal’s Name:_____________________________________

SECTION B
Parent/Caregiver/Guardian Information – to be completed by the head of the household
What is your relationship to the applicant? Parent Relative Legal Guardian Caregiver Other
Your Full Name:______________________________________________________________________________

Employer:_____________________________________ Gross Monthly Income: ___R_____________________

Your Contact Details: (w)_____________________(h)______________________(cell)_____________________

Spouse/Partner’s Full Name:____________________________________________________________________

Employer:___________________________________ __Gross Monthly Income: ___R______________________

Spouse/Partner’s Contact Details: (w)_________________(h)_________________(cell)____________________

Number of people in your household, including yourself:____________________________________________

Other Income: ____R________________________ Total Monthly Expenditure: ____R_____________________

Please specify the source of “Other Income”, if applicable:___________________________________________

Your family’s expenditure covers the following items (please tick):
Your family’s expenditure covers the following items (please tick):
Home rental OR Bond Clothing and other accounts Water & Electricity bills
Vehicle repayments & Insurance Personal Loans OR Credit Card Entertainment
Transport Medical Aid Groceries
Life Insurance School OR University Fees Child Maintenance
Pension OR Provident Fund Telephone bills Other

If “Other”, please specify:__________________________________________________________________________

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SECTION C
To be completed by the scholar/applicant

Write a paragraph, maximum 60 words, starting “If I was a CEO of a company, I would.…”
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SECTION D
Parent/Caregiver/Guardian Information – to be completed by the head of the household

How did you hear about the SSP Scholarship? Library Radio Newspaper School Word of mouth

DECLARATION

I, _______________________________________________, sign to acknowledge that I understand the terms and

conditions set out in this document, that the information I have provided, is true and accurate and that the
written work submitted is the work of the applicant, unaided by any other person and is written in the applicant’s
own hand.

Signed: ____________________________________________ Date:____________________________

COMPLETED APPLICATION FORMS MUST BE HAND-DELIVERED AS FOLLOWS:

From Monday 1 June 2015 until Monday 31 August 2015 must be submit to:
Please identify your nearest library from the following list:

East London Central Library

Gladstone Street
East London

Buffalo Flats Library

Greenpoint Road
Buffalo Flats

Gompo Library
Bottoman Street
Gompo Town

Gonubie Library
Gonubie Municipal Offices
Main Road

Mdantsane Library
Dunga Road, NU2
Mdantsane

Vincent Library
Corner Frere & Donald’s Road
Vincent