APPLICANT ID KUMBEN
NSFAS
National Student Financial Ald Scheme Consent Form
APPLIGATION FOR FINANCIAL ASSISTANCE TO STUDY AT A PUBLIC UNIVERSITY OR TVET
COLLEGE
NSFAS requires personal information from agencies relating to the
of the applicant. NSFAS is committed to ensuring that the personal employment
status
informatlon obtainedand
fromlevel
th of income of the parents or guardians
protecting the privacy of the persons whose personal information is made available to NSFAS, third parties is treated confidentialy and to
the personal infomation and to use that personal informatian in a lawful manner. You and NSFAS is further committed to protecting
your
provide consent for NSFAS to use and verify the information you provide by signing this form. parent/guardian/ spouse are required to
Iconfim that by voluntarily submitting any persanal information to NSFAS, in any form, it
Consent for NSFAS to share such personal information with third parties, and to obtain relevant constitutes an indefinite unconditional and specific
information
include government departrments and entities, credit bureaus, institutions of higher learning and other agenclesfrom third parties Thi parties
for the purpases of infoma
validation, reporting, statistical analysis, credit and income validations to assess my financial eligibility, criminal checks, amaton
and record-keeping purposes, debt tracing and/ or debt recovery purposes, securing funding on my legal proceedings, audit
registratin data as required. The personal informatian to be obtained from SARS shall relate only tobehalf and to verify academic and
the employrnent status and income
DATE OF SIGNATURE
SIGNATURE OF
APPLICANT
GUARE OF FATHERI DATE OF SIGNATURE
SURNAME, INITIALS
I0 NUMRER
CELL PHONE NUMBER
SIGNATURE OF MOTHERI DATE OF SHG NATURE
GUARDtAN
SURNAME, INITIALS
N o BoAD
ID NUMBEH CLL PHOHE IUMBER
O63-26S8
DATE OF SIGNATURE
SIGNATURE OF SPousE
PARTNER (If applicable)
SURNAME, INITIALs
ID NUMBER CELL PHONE NUMBER
YDisclaimer and signature of applicant
By signing this consent form, I accept and understand that this application does not guarantee that I will receive NSFAS administered funding, I
acknowledge that any personal infomation and supporting documentation supplied to NSFAS is done so voluntanily in order to facilitate the
processing of this application. I furthermore acknowledge that the information provided by me, is to the best of my knowledge both true and
correct, and that understand that any false or inaccurate information or documentation submitted may render the application ineligible and Imay
be subiect to legal actian. I understand and accept that if my application for financial aid is approved as eligible, funding is only confirmed and
processed on receipt by NSFAS of valid registration costs from a public higher education institution for an approved funded programme Iaccept
anted would
grantedv be governed by the National Bursary Rules and Guidelines of the Department of Higher Educatcaton, Scen
and Technology which may be amended annually, and that I willcomply with the annual requirements of funding NSFAS will provide a fulil
National Bursary Agreement on receipt of valid registration data.
By submitting this application, I understand, acknowledge and accept the terns and conditions contained in the NSFAS Bursary Agreement
The NSFAS Bursary Agreement terms and conditions can be found on the NSFAS website (www.nsfas.org za) or contact our toll free
number 0800067327 for any queries DATE OF sIGNATURE
SiGNATURE
OFAPPLICANT
