UP with SCIENCE BURSARY AGREEMENT Form, 2016

UNIVERSITY OF PRETORIA UP with SCIENCE BURSARY AGREEMENT Form 2016 Academic Year Please note the following:  Complete the form in black ink  Do not use correction fluid  Sign next to all alterations  Sign all pages BURSARY AGREEMENT for FULL‐TIME STUDY STUDENT NUMBER Title: _________ Initials: _________ Surname: ___________________________________________ Identity number Degree Year of study ____________________ Year in which UP with Science MOU (grade 10) was signed _______________ I, ________________________________________ (full names and surname) (hereinafter “the bursary holder”), hereby accept the bursary awarded to me by the University of Pretoria (hereinafter “University ” or “UP”) to the maximum amount approved by the University. The bursary is awarded subject to the following conditions: 1. The bursary holder must be a South African citizen or a permanent resident. 2. The bursary holder must be registered at the University as a full‐time undergraduate student for the duration of the 2016 academic year for the degree indicated above. 3. The bursary holder may not accept other bursaries or stipends without first notifying the Division for Study Finance at the University in writing of such a possibility and after receiving written confirmation that it is approved. In such instances an amount equal to the additional financial support may be deducted from the UP with Science bursary. 4. The bursary holder has acquainted him‐/herself with the conditions, rules and regulations applicable to this bursary. 5. Should the bursary holder terminate his/her studies or not complete his/her studies within the minimum prescribed period as indicated in the General Regulations of the University of Pretoria, the bursary may be terminated. 6. The bursary holder must progress to the next year of study according to the requirements determined by the University to qualify for the bursary for the following year. If the bursary holder does not progress to the next year of study, this will not lead to the cancellation of the bursary, but will have the effect that the bursary will be postponed for a year, and the bursary holder will be responsible for paying all study fees in the repeating year: Provided that this arrangement will be considered for only one such occasion and any further extension of the period of study will result in the cancellation of the bursary.. 7. In the event of the studies being cancelled by the University due to unacceptable conduct by the bursary holder or for any other reason, the bursary may be terminated Signature: Bursary Holder
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Signature: Witness 1
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Signature Witness 2
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Signature: Guardian/Parent (if student is a minor) ________________________________
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Should the bursary be cancelled in accordance with paragraphs 5 or 6 above, the full bursary amount or a pro‐rata amount as determined by the Manager: Division for Study Finance will be repayable by the bursary holder. 9. The bursary holder must notify UP of any changes in the circumstances under which the bursary was awarded or any change which might affect the bursary. Should the bursary holder fail to do so, the bursary may be cancelled by UP with reasonable written notice to the bursary holder. 10. The bursary holder must notify UP in writing of any change of address within 30 days from date of change. 11. Should the bursary holder fail to fulfil any of the above conditions or should the bursary be awarded on the basis of false information supplied to UP, UP would be entitled, with due written notice to cancel the agreement. 12. Should the bursary holder not perform in terms of this agreement, and UP institute legal action, the bursary holder will be liable for the payment of all costs incurred on a scale of attorney and client. The bursary holder elects for all purposes pertaining to this agreement as domicilium citandi et executandi, unless changed in writing, the following physical address (PO Box not acceptable): ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… and further agrees to the jurisdiction of the Magistrate’s Court in accordance with Section 45 of Act 32 of the Magistrate’s Court Act of 1944, as amended, for any legal action that may arise from this agreement. 13. The division for Study Finance will administer the bursary on behalf of the bursary holder. The following costs will be covered by the bursary: 13.1 Initial fees payable towards tuition. 13.2 Tuition fees on courses in accordance with the memorandum of agreement as signed between the bursary holder and UP. I hereby declare and confirm that the information supplied is true and correct. ACCEPTED and SIGNED at Pretoria on this ……. day of …………………………………… (month & year) …………………………………..….. …………………………………………… SIGNATURE of bursary holder (“the student”) * SIGNATURE of PARENT/GUARDIAN (Assisted by his/her parent/guardian, if a minor) e‐mail (student) ………………………………..……………………………….. Telephone number, (student, cell) …………………………………………………….., AS WITNESSES: 1. ……………………………….. 2. …………………………………………… Please supply the following details of one member of your family or a friend (not residing at the same address): Surname Full Name(s) ID Number Complete Postal Address Complete Residential address Telephone number (H) Telephone number (W) Telephone number (Cell) The bursary holder participated in the “UP with Science” programme of UP (Group ……...........) and therefore qualifies for the tuition scholarship in the Faculty of Natural and Agricultural Sciences, as set out in the Memorandum of Agreement between the bursary holder and UP. …………………………………………………………. ………………………………… …………………… …………………………………………… Name (UP with Science Manager) Signature Date Place Page 2 of 2