Support - Hardship Fund - Queen`s University Belfast

Support - Hardship Fund – Information Sheet & Application Form 2013/14
Support Fund
The Support Fund is used to provide discretionary financial help for students who get into financial difficulty
during their course.
Hardship Fund
The Hardship Fund is available to students who are not eligible for the Support Fund. There is a smaller
amount of money in the Hardship Fund, so circumstances must be exceptional for an award to be made.
Students, who are not eligible for the student support fund, are automatically referred to the Hardship Fund.
Who can apply for the Student Support Fund?
All full-time and part-time (50% of equivalent full-time course) Northern Ireland and Great Britain
undergraduates and postgraduate students can apply.
Undergraduate students must have taken out their maximum Fee & Maintenance Loan entitlement.
All students must demonstrate that they have organised sufficient funding for their course. The Support Fund
is a discretionary fund and should not be viewed as a means to fund a course. For details of the University’s
current payments options for tuition fees, please refer to http://www.qub.ac.uk/TuitionFees
Any eligible student who has a particular financial need can apply.
Prior to Submission of Application
If you require any assistance completing your application form please contact:
Connie Craig – Advice Centre Manager
Student Financial Adviser
2nd Floor Students’ Union
Email: connie.craig@qub.ac.uk
or
Debbie Forsey
Money Management Adviser
2nd Floor Students’ Union
Email: d.forsey@qub.ac.uk
Application Process
You can pick up an application form from the Income & Finance Office at the Student Guidance Centre.
To download an application, please visit our website www.qub.ac.uk/StudentSupport
Completed application forms with all documentation should be forwarded to or handed in at:
Income & Student Finance Office, Student Guidance Centre, Queen’s University, Belfast, BT7 1NN
Tel no 02890 972854, email supportfund@qub.ac.uk
Every applicant will receive an email, to their QUB email address, confirming receipt of their application.
Students will be advised by email of the decision within 4 weeks of submission of their application. However
during peak periods, prior to Christmas and Easter, processing of applications may take longer.
No decision will be discussed over the phone. Awards made by the Support or Hardship Fund do not
have to be repaid.
Students have the right to request a review of any decision in connection with their application. Reviews
should be requested in writing, clearly stating the grounds for appeal and where appropriate, supplying
additional documentary evidence to support the review process. Requests must be received within 14 days of
the date of the original decision, addressed to the Chairperson of the Support Fund Committee, and returned
to the Income & Student Finance Office, Student Guidance Centre.
After you receive the outcome of your review, if you still disagree with the decision, you may appeal to the
Support Fund Appeals Panel, who are responsible for handling the final appeal. You should clearly indicate
how you believe an incorrect decision has been made. The Panel will review your case and inform you of their
decision in writing.
Additional Information
You must provide evidence of your financial circumstances. Failure to provide the evidence requested will
delay your application. Forms submitted without correct documentation or not completed fully will not
be processed. You will be notified by email, to your QUB email address, about missing or incomplete
documentation. You will have 4 weeks from the date of the email to provide this documentation
otherwise your application will be deemed to have lapsed.
Awards are assessed based on specific criteria, for full details of these please visit our website
www.qub.ac.uk/StudentSupport
Please note that students whose bank statements indicate gambling are not eligible for a direct
payment. If awarded, depending on individual circumstances, a payment can be made to a 3rd party.
Students in receipt of benefits, to which they are not entitled, are not eligible to receive an award.
If you have an outstanding Emergency Loan or Institutional Bursary overpayment, any award from the Support
Fund may be used towards repayment of this debt.
Random checks will be made on individual applications and any found to be fraudulent will result in disciplinary
action.
There is no automatic entitlement to an award for any student. Awards are subject to money being available in
the Fund.
Students on occasion may be referred to other support services within the University. These may include:
Money Management Adviser, Debbie Forsey
d.forsey@qub.ac.uk
Connie Craig, Advice Centre Manager, Financial Adviser
connie.craig@qub.ac.uk
Disability Services
disability.office@qub.ac.uk
Learning Development Service
lds@qub.ac.uk
Counselling Service
counselling@qub.ac.uk
SUPPORT FUND / HARDSHIP
APPLICATION 2013/14
For Office Use Only
Student Support No:
Personal Details
Student Number:
Name:
(print)
Home Address:
Date of Birth:
Contact Tel No:
Bank Account Details*
Name(s) of Account Holder(s):
Account Number
Sort Code
Name and Address of Bank
*Awards are paid by BACS directly into your bank account so it is vital that you give the correct details
Course Details
Course Title:
Are you:
Undergraduate
Are you:
Full-time
If you are a Nursing Student are you:
February Intake
Is this your final year?
Yes
Is this your second undergraduate degree?
Yes
☐
☐
No
No
☐
☐
☐
☐
☐
Postgraduate
Part-time
September Intake
☐
☐
☐
Is this a placement year?
Yes ☐ No ☐
Paid ☐
Unpaid ☐
Are you spending the year overseas as a compulsory part of your course? (If you have elected to
study, work overseas, please select No for this question)
Yes
☐
No
☐
For Office Use Only
Receipt Emailed
O/S Info
Requested
O/S Info Rec’d
Complete
Referral
Reason
Student Loan
Have you taken out in this academic year your full loan & grant entitlement (both maintenance and
fees) from Student Finance? (Only applicable to UG and PGCE students)
Tuition Fee Loan *
Yes
Maintenance Loan *
Yes
☐
☐
No
No
☐
☐
☐
☐
N/A
N/A
* If yes to any of the above, please provide the FULL Student Finance Notification & Breakdown
Marital Status
Single ☐
Married
☐
Civil Partnership ☐
Divorced ☐
Lone Parent ☐
☐
Co-habiting
Accommodation details
Do you live: 1. in rented accommodation
4. with parents or guardian
☐
☐
2. in a hall of residence
5. with your partner or spouse
☐
☐
3. Home Owner
6. Other *
☐
☐
* If Other please give details:
If you live with your partner or spouse are they:
Working ☐ Studying
☐
In receipt of benefits
☐
Other * ☐
If Other please give details:
Dependants
We understand persons with dependants to be those with personal responsibility for the care of a child, the
care of a person with an incapacitating disability and/or the care of a dependent elderly person.
Please list anyone in your household who is financially dependent on you.
Name
Relationship to You
Date of Birth
Do you have a disability? (only tick yes, if you are registered with Disability Services)
Are you in receipt of Disabled Students Allowance (DSA)?
Yes
☐
No*
Yes*
☐
No
☐
☐
*If No and you have a disability, please contact Disability Services for further information and to
discuss eligibility.
If you wish to apply for funding towards the cost of a diagnostic assessment, please contact Disability
Services.
Student & Partner’s Declaration of Income
Documentation Required Checklist (Please attach COPIES not originals)
£
Yearly Income
SLC Maintenance Loan
SLC Maintenance/Special
Support Grant
Parents Learning Allowance
Please tick the boxes (if applicable) to show that the
information has been provided
Student Finance Financial Notification &
Finance Breakdown for 13/14
Student Finance Financial Notification &
Finance Breakdown for 13/14
Student Finance Financial Notification &
Finance Breakdown for 13/14
Adult Dependants Grant
Student Finance Financial Notification &
Finance Breakdown for 13/14
Child Care Grant
Student Finance Financial Notification &
Finance Breakdown for 13/14
Other Grants
Please provide relevant documentation
Nursing/Social Work Bursary
DHSSPS Notification Letter and Breakdown
Income Support/JSA/Other
means tested benefits
Letter from Benefits Office
Housing Benefit
Letter from Housing Executive
Working Tax Credit
2013/14 Full Notification from HMRC
Child Tax Credit
2013/14 Full Notification from HMRC
Childcare Element of Working
Tax Credit
2013/14 Full Notification from HMRC
Maintenance Payments
Please provide relevant documentation
QUB/Del Stipend
Please provide relevant documentation
Other Income (please specify)
Please provide relevant documentation
Personal take home earnings
Wages/Pay advice slips/P60
Partner’s take home earnings/
benefits
Wages/Pay advice slips/P60/Set of accounts
if self-employed/letter from Benefits Office
Total Income £
3 Months Recent Bank Statements, for all accounts held in your name
(Not Mini Statements)*
SHOULD BE INCLUDED WITH YOUR APPLICATION
☐
*All transactions must be visible
Student Finance NI Financial Notification 2013/14, please also include breakdown, these can
be downloaded from: www.studentfinanceni.co.uk using Customer Reference Number
Student & Partners Expenditure
Documentation Required Checklist (Please attach COPIES not originals)
£ Monthly
Please tick the boxes (if applicable) to show
that the information has been provided
Rent or Mortgage
Tenancy agreement/letter from
mortgage provider/proof of
payments on bank statements ie
standing order to Landlord, with
Landlord’s name visible on a
minimum of 2 months statements.
Rates
Notification from Land & Property
Services
Childcare costs
Confirmation from the
Nursery/Crèche/Registered Childminder, detailing weekly charge on
headed paper. If your child care
provider is a Registered Childminder please provide copy of their
registration certificate. Please
note, no costs will be allowed
for non-registered childminders.
Disability costs not
covered by DSA
(please specify) and/or
Medical costs
Please provide relevant
documentation
Debts
Do you have any debts? Yes* ☐
No ☐
Have you previously or are you currently using pay day loans as a source of finance? Yes* ☐
No ☐
If yes, to either of the above, please give details and provide supporting documentation (do not include student
loans or your main bank overdraft)
Company
Reason for loan
Balance owed
Minimum monthly
payment
Are you still using this
source of credit?
Travel Costs
Student
Weekly Travel
Costs
Yes * ☐
Do you travel by Public Transport?
No ☐
*If yes, state:
Cost of return journey (see below) £ ________ &
Number of return journeys _________
For students living away from home, the cost of one return weekly journey will be allowed.
If you have more than 1 return journey in a week, please provide an explanation:
Yes * ☐
Do you travel by Car?
*If yes, state your mileage per week:
No ☐
__________ miles per week
Assessments can generally only include car costs for students who require a car because of
disability, students with dependants, those attending certain placements.
Those who can’t use public transport for a particular reason, please outline below.
Partners
Weekly Travel
Costs
(If applicable)
Yes * ☐
Do they travel by Public Transport?
No ☐
If yes, state:
Cost of return journey (see below) £ ________ &
Number of return journeys _________
Yes * ☐
Do you travel by Car?
*If yes, state their mileage per week:
No ☐
__________ miles per week
For Office Use Only
Student’s weekly travel
cost - Public transport
Cost of return
journey
Student’s weekly travel
cost -car
Mileage per week
Partner’s weekly travel
cost - Public transport
Cost of return
journey
Partner’s weekly travel
cost - car
Mileage per week
£
No of journey
allowed
Assessment period
Total travel cost
£
Total travel cost of
Student & Partner
£
£
£
£
No of journey
allowed
£
£
£
Course costs, do not include Tuition Fees, Books and Print Credits/Photocopying Costs
Please provide details:
Cost incurred: £
Provide evidence of cost, i.e. receipt; please note no costs will
be allowed unless receipts are provided.
Exceptional costs i.e. repair/replacement of essential equipment or costs arising as a result of
unforeseen circumstances.
Please provide details:
Cost incurred: £
Provide evidence of cost, i.e. receipt; please note no costs will
be allowed unless receipts are provided.
PERSONAL STATEMENT
Please state below why you are in financial difficulty and why you believe your situation to be exceptional and
to merit additional support. Please only include details which are relevant to FINANCIAL hardship.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
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STUDENT DECLARATION – please read and tick
☐The information given in this form is correct and complete to the best of my knowledge
☐ I have checked and enclosed ALL ESSENTIAL relevant documentary evidence.
☐ I have enclosed copies of 3 months recent bank statements (not mini-statements)
☐ I have enclosed a copy of my Student Financial Notification & Breakdown for 2013/14 (if applicable)
☐ I have enclosed copies as requested as information will not be returned.
☐ I understand that random checks will be made on individual applications and any found to be
fraudulent will result in disciplinary action
I understand that the information contained in this form and attachments are held for the purpose of assessing
my application for Support Funds. I understand that this information may be disclosed to the Department for
Employment and Learning and/or the Student Loans Company, in accordance with the Data Protection Act. I
further understand that third parties referred to in my application may be contacted to seek independent
verification of the information supplied.
Signed:
__________________________________ Date: ____________________________________