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Bursary Application Form

Pupil's Name:
Date of Birth:
Year/Term of Entry:

Parents (See Note 1)

Father/ Step Father/ Guardian Details:

Mother/Step Mother/ Guardian Details:

Capital Assets and Liabilities

Please enter below details of your Capital Assets and Liabilities, with all financial values shown in sterling. Please provide proof of all assets and liabilities e.g. bank statements.

All information provided will be treated in the strictest confidence.

 Father/Step Father/ GuardianMother/ Step Mother/ Guardian
a) Approximate market value of all investments
i) Building Society/Bank Deposits
ii) Equity Investments, Government Stocks
iii) PEPs, ISAs, NISAs, TESSAs
b) Approximate market value of principle residence
i) Is the property freehold or leasehold?
c) Approximate value of additional properties owned in UK
i) Approximate value of additional properties owned abroad
d) Approximate market value of other possessions including house contents, car etc.
e) Cash at bank or elsewhere (Current Accounts only)
f) Any other assets - please specify asset and give value

Capital Liabilities (See Note 3)

 Father/ Step Father/ GuardianMother/Step Mother/ Guardian
g) Mortgage - Amount outstanding
i) Mortgage - Final repayment date
h) Other liabilities (please specify)
Total Assets
LESS Total Liabilities

Current Earnings

Please enter below your current earnings and expected income from all sources for the tax year 2021 - 2022.

 Father/Step Father/GuardianMother/Step Mother/Guardian
a) Salary/wages
i) Gross
ii) Less Tax
iii) Less NI
iv) Benefits in Kind
b) Business profits/dividends (please give details)
c) Investment Income
i) Bank Interest
ii) Dividend Income
iii) Rental Income
d) Tax Credits/ Income Support
e) Maintenance Allowance received from previous partner
Total Income (Individual)
Deduct cost of living allowance (- 30,000)**
Deduct annual school fees for other pupils at the Foundation Schools (please give details)
Add fee support received from outside agencies (See Note 5)
Add fee support from other family members

** Should your cost of living be significantly lower than amount given above, please provide details as to why in the next section.

Additional Details

Please use this section to give more details where applicable.


After having read the attached notes, the following declaration should be signed by both parents/applicants.

(Please indicate if divorced/separated/widowed)

We/I have read the notes and have made a complete declaration of our/my income and assets.

We/I understand that if we are/I am offered an Award for our/my child and accept a place for him/her at the school:-
a) our/my child’s fees account with the School will be credited termly with the amount of the Award;
b) any award or grant is subject to annual review and we/I must complete an annual declaration of our/my financial circumstances on the form sent to us/me by the School and supply all relevant supporting evidence by the return date indicated;
c) we/I must undertake to report immediately any material change in the financial position declared;
d) the Award may be withdrawn or reduced, and in certain circumstances, past payment reclaimed if:

i) there is a breach of the School’s
Terms and Conditions attached to the acceptance of a place for our/my child at the school; ii) we/I have knowingly and/or recklessly provided false information;
iii) we/I have failed to return the annual declaration of our/my financial circumstances by the return date indicated;
iv) we/I have failed to produce any additional information required by the Charity to evidence our/my financial circumstances;
v) there is in the view of the Head either unsatisfactory work or conduct;
vi) the Charity’s resources are insufficient to maintain the level of Award