APPLICATION FORM 2018: TERTIARY EDUCATION …

1 PRIVATE BAG X943 PRETORIA 0001; 328 FESTIVAL STREET HATFIELD PRETORIA 0083 APPLICATION form 2018 : TERTIARY EDUCATION support TO BE COMPLETED BY MILITARY VETERAN OR DEPENDANT APPLYING FOR EDUCATION support ( TERTIARY ) SECTION 5 (1) (d) MILITARY VETERANS ACT 18 (2011) NB: This APPLICATION form must be completed in full, failure to do so will result in disqualification of the APPLICATION PART 1: CONDITIONS applications for 2018 open on 01 August 2017 and close on 30 September 2017. (No late applications will be accepted) Only eligible Military Veterans and Dependants registered on the NMV Database will be considered for EDUCATION support . (No applications will be considered if applicants are not registered on the Military Veterans Database by date of APPLICATION ) NB: Only fully completed and signed APPLICATION forms will be considered.

2 Incomplete applications will be disqualified. ( Information omitted or required supporting documents are not attached) Each dependant must have an APPLICATION form completed (If more than one dependant is applied for) Approval of applications will be subject to the availability of budget at the DMV, as well as the verification of the Military Veteran s income with SARS or any other authorised State entity, as there is a huge demand for the EDUCATION benefit not congruent with the budget. PART 2: REQUIRED DOCUMENTS Please attach the following documents to the APPLICATION : Certified copies of: Military Veteran s identity document/Death certificate if veteran is deceased. Applicant s identity document. ID copy of parent/Guardian if applicant is not a Military Veteran. Latest school report or statement of results Military veteran /Guardian proof of employment and income Latest salary advice.

3 If unemployed an affidavit stating the Military veteran /Guardian employment status.( 3 months bank statement to be provided still) Military veteran /Guardian 3 months bank statements.(Recent) If dependant s surname is different to the military veteran, an affidavit stating the reasons. Letter of Acceptance or proof of registration at the institution for 2018 . Proof of Residence (original) APPLICATION form : S51D Page 2 of 4 PLEASE INDICATE BY MEANS OF AN X IF THIS IS A NEW OR CONTINUING EDUCATION support APPLICATION FOR 2018 : NEW CONTINUING PART 3: PERSONAL DETAILS OF MILITARY VETERAN Surname Full name Title Marital Status Identity Number Force number & Former Force Contact No (Cell) Mil Vet/ Guardian Email Address of Mil Vet/Guardian Contact No Student Email Address student Physical Address Post Code: Postal Address Post Code: Province of Origin/residence: Province of Study Institution: Confirmation of EDUCATION support : (Mark X to Confirm) TERTIARY EDUCATION Full names and Surname of Student (One APPLICATION form per dependant) Are you as a Military Veteran, employed?

4 YES NO Gross income range per month: Mark (X) R3,000 -R5,000 R5,001 -R10,000 R10,001 -R20,000 R20,001 -R30,000 +R30,001 Page 3 of 4 PART 4: ADDITIONAL INFORMATION Is this APPLICATION for: Veteran Dependant ID No of Student: Full names and surname of Applicant: Relationship of applicant/student to Military Veteran Is the Military Veteran registered on the National Military Veteran Database? (On date of this APPLICATION ) Yes No Is the dependant registered on the National Military Veterans Database? (On the date of this APPLICATION ) Yes No Has the applicant been awarded with a bursary from DMV before? (If Yes, indicate the year of Award) Yes No Indicate the level (year) of study (First/Second /Third year, etc) When do you expect to complete your studies? ( 2018 /2019/2020) State the duration of the entire course (2,3 4,5 YEARS) State if it is a Public or Private Institution Details of Educational Institution Name of Institution where the student is accepted for 2018 Name of the contact person at the institution Address of the EDUCATION institution Post code: Financial Contact person: Tel: Fax: Email address: PART 4: DECLARATION I, the undersigned (Full Names) _____ 1.

5 I am the applicant/veteran whose names appear in this APPLICATION form ; 2. The completed content of this APPLICATION form , to my personal knowledge, unless stated otherwise and is both true and correct; 3. I further permit the Department of Military Veterans to conduct my income verification. _____ _____ DEPONENT SIGNATURE DATE NB: This APPLICATION form must be completed in full, failure to do so will result in disqualification of the APPLICATION Page 4 of 4 OFFICIAL USE ONLY Copy of Military Veteran ID or death certificate Attached/Not Attached Copy of Applicant ID/Birth Certificate Attached/Not Attached Affidavit clarity on child surname Attached/Not Attached Proof of Residence Attached/Not Attached Latest 3 months Bank statements Attached/Not Attached Proof of employment/ Affidavit if unemployed Attached/Not Attached Proof of Income Attached/Not Attached Latest Educational progress report Attached/Not Attached Letter of acceptance/Proof of registration to the educational institution Attached/Not Attached APPLICATION RECEIVED AND CHECKED BY.

6 _____ (NAME IN PRINT) _____ (SIGNATURE) DATE APPLICATION RECEIVED: _____ (DD/MM/YYYY)