City Lit Student Bursary
Have you had a bursary before? Yes/No please delete where necessary.
If yes, How much?
In which country have you been ordinarily resident in the last three years?
Other UK/EEA country – please name the country:______________
Country outside of EEA – please name the country:___________________________
What course are you intending to take at City Lit?
Course Code Course Title
Details of your income and savings: (please tick)
Do you work? Yes No Do you have a pension? Yes No
If yes, what is your household
income per week/month? (please
Do you receive any benefit or working tax or child tax credits? Yes No
If yes, which benefit do you receive?
How much do you receive per week/
fortnight (please delete)
Do you have any savings? Yes No
If yes, how much?
Please tell us why you wish to take this course: please attach a separate sheet if necessary
What are your plans after completing this course? Include details of your career or
academic/ education plans.
What qualifications do you have already?
Please give details of any personal circumstances that you feel we should take into
consideration (any information given will remain confidential). Please attach a separate
sheet if necessary
I have informed you of all my income and savings, and all the information I have given is
Please return with proof of financial situation by email to: firstname.lastname@example.org or by post to:
Information and Advice
Once you return the form it will be passed to the Bursary panel for consideration. It can take up to two weeks for your
application to be processed.
For further information please contact the Information and Advice shop on: 020 7492 2500 or email@example.com
Please note that the student bursary is a limited fund
Information provided on this form will be used for the purposes described and will be processed in compliance
with the Data Protection Act 1998. Further information about data protection is available on request.