Bursary Application

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Student Details
Name of student*
First Last
Date of Birth*
Day
Month
Year
Last Course Attended
Name and date of course to be attended in the current academic year*
Instruments for which a bursary is required*
School attended*
State or independent?*
- State
- Independent
Parental details
Name of parent(s)*
Home Address*
Street Address Address Line 2 City Postcode
Main contact phone number*
Main contact email address*
Financial details
Expenditure on music tuition per annum*
Father's occupation*
Where applicable or "n/a"
Father's Gross Annual Salary*
Where applicable or "0"
Mother's occupation*
Where applicable or "n/a"
Mother's Gross Annual Salary*
Where applicable or "0"
Gross Annual income from Property*
Gross Annual Income from Savings*
Total Net Annual income after tax including the above plus any other income*
Total value of savings, excluding pensions*
Total value of properties owned*
Number of dependent children (under 18)*
Bursary details
Reason for seeking a bursary*
Describe what attempts have been made to secure funding from elsewhere and the result of these attempts*
Any other circumstances you wish to bring to our attention
Pro Corda reserves the right to request evidence of income and outgoings as set out in this form and to seek further clarification from applicants as necessary.

In accepting bursary support, your child agrees to submit a report of their course experience and/or an acknowledgement to the relevant charitable trust as part of Pro Corda’s reporting requirements. Any reports must be submitted to Pro Corda within one month of the course ending. You accept liability for the full course fees if this is not adhered to.

Failure to fill out this form in its entirety will prejudice your application for a bursary.
Declaration
Father's Consent*
I accept the conditions set out in this form
I accept all of the conditions set out in this document. I declare that, to the best of my knowledge and belief, the information given is correct and it is a true representation of my financial circumstances. I authorise Pro Corda to disclose and discuss with relevant third parties any information provided on this form.
Mother's Consent*
I accept the conditions set out in this form
I accept all of the conditions set out in this document. I declare that, to the best of my knowledge and belief, the information given is correct and it is a true representation of my financial circumstances. I authorise Pro Corda to disclose and discuss with relevant third parties any information provided on this form.

Bursary Application

Student Details

Parental details

Financial details

Bursary details

Declaration

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Further Details