PLEASE CHOosE WHETHER A SOCIAL WORKER OR YOUR SCHOOL PRINCIPAL IS To cOMPLETE ONE OF THE Two

SECTIONS BELOW:

T o be completed by Social Worker

1, the undersigned (Full Name and Surname) in my capacity as

(position) at the Department of Social Development hereby confirm that the
declaration andinfomation
of student) 11Z 7
providedby the ApplicantV4
t o
yi4LbisaL D
(Name and Surname
number student); is to the best of my knowledge, both true and correct.

DATE OF SIGNATURE
6IGNATURE OF
SOCAL WORKER
2 2 o6
D NUMBEROF SOCIAL WORKER
CELLPHONE NUMBER

6 4 3 5o 2 3 7 2-6 2z 2
SACSSP REGISTRATION NUMBER EMAIL ADDRESS

o37515
To be completed by Principal of school last attended

1, the undersigned _(Full Name and Surname) in my capacty as- (pusition) at the
(Name of School) hereby confirm that the declaration and information provided by the
Applicant (Name and Sumame of student)_ (ID number student):
is to the best of my knowledge. both true and correct.

EMIS NUMBER
EMAIL ADDRESS

SCHOOL NAME

ID NUMBER
CELLPHONE NUMBER OF PRINCIPLE

DATE
SIGHATURE OF APPLUCANT

SCHOOL STAMP

Y Disclaimer and Signature of Applicant

By signing this application fom, I accept and understand that this application does not guarantee that I will receive NSFAS administered
funding. I acknowledge that any personal information and supporting documentation supplied to NSFAS is done so voluntarily in order to
faciltate the processing of this application. I furthermore acknowledge that the infomation
provided by me, is to the best of my knowledge
both true and correct, and that I understand that any false or inaccurate information or documentation submitted render the
may application
ineligible and I may be subject to legal action. I understand and accept that if my application for financial aid is approved as eligible, funding
onlyconfimed and processedon receiptbyNSFAS of validregistration costsfrom a public higher education institutionfor an approved
funded programme. I accept that funding granted would be governed by the National Bursary Rules and Guidelines of the Department of
Higher Education and Training which may be amended annually, and that I will comply with the annual requirements of funding. NSFAS will
email a full NSFAS Bursary Agreement on receipt of valid registration data.

Bysubmitingthis application, Iunderstand. acknowledge and accept thetermsand conditions contained in the NSFAS Bursany Agreement
The NSFAS Bursary Agreement terms and conditions can be found on the NSFAS website www.nsfas.org.za.

DATE
AGNATU
oF STUDENT
(SMagi 2o 2 2ob
APP2022V1