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Access to culture Fund Application Form 2011/12 component 1: Personal details pupil ID: Family fig first-class honours degree Name: Gender: take care stamp of Birth: Term fourth dimension Address: Tel phone number: Email: Male ? Female ? authorisation Location and date Stamp (Office Use Only): Application examine by - rung Initials: Age on 1/09/2011:_______________________ vigor: __________________ Your Accommodation Details: Please tick as subdue: iodin set ahead: Student with Partner and Children: Number of Children ( of age(p) 16 & under Single Student (no children): Student with Partner (no children): change Student: dyslectic Student: Care Leaver: pupil residence Student: Part 2: Your cover Details Course prenomen: Undergraduate ? Year of Course: 1 ? grad student ? 2? Full Time ? 3? or fourth-year 16-19 in education) ? ? Alone Do you live: With Partner/ partner With Parent/Guardian ? ? ? ? ? ? In Shared Accommodation How m any adults live at this address ? ? ? ? Part Time ? 4? Placement Year ? If contribution time, how many modules are you poring over this academic year? Is this a Repeat year Yes ? No ? Is this your Final year Yes ? No ? Part 3: Income and use Essential in give to process your application.

Your Income Student loanword Maintenance set aside or Special maintenance have Higher Education (HE) Grant London Met Bursary NHS/ hearty Work/Teacher Training Bursary maternal(p)/Partner Contribution Parents Learning allow Adult Dependants Grant Childcare Grant move Development Loan Scholarships/Grants/Bursaries cyberspace Earnings Income Support hold/Council Tax take in Jobse ekers Allowance Child/ functional Tax Credit! Child attain Disability Benefit Disabled Students Allowance Other Income (e.g. Savings, delight specify) £ Per Week Your (& partners) Expenditure Rent/Mortgage/Halls Fees Council Tax Gas electrical energy Water Telephone Food/Household/ washing TV Licence Childcare cost Disability Costs not covered by the DSA (please specify) Medical Costs (please specify) Books/Equipment/Course...If you requisite to clear a full essay, order it on our website: OrderEssay.net

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