AFRICA EMPOWERMENT TRUST Youth Programme - Bursary The CIPS Africa Broad-Based Empowerment Trust would provide bursaries to young individuals, who are either an existing CIPS student, or wish to become a CIPS member and study the CIPS qualification. The purpose of the bursary is to provide financial assistance to young individuals who cannot be able to fund their CIPS qualification. A bursary would cover the cost of: • • • • • One year membership fee (if you are an existing member) One year membership and once-off registration fee (to new members) Course books Examination registration Invigilation fee (depending on the exam centre) The Bursary is limited to one level per annum and will be awarded to completion of level 2 up to level 4 Requirements • • • • • • • • • • • Individual must be between the ages of 18 to 25 years old Completed Application form 2 page C.V A valid South African ID or any other supporting proof of identification (depending on the Nationality) Matric Certificate 3 months bank statement and payslip (if applicant is employed) If the applicant is un-employed, a sworn affidavit stating un-employment Parents or guardians 3 months bank statement ( If Employed) Should parents or guardian be unemployed , sworn affidavit stating unemployment If parents or guardians are deceased , kindly send a copy of the death certificate Motivation letter( No longer than 300 words) motivating why you should be considered for the bursaries Responsibilities of Recipient Statement from/interview with awarded recipients may be posted on various forums on procurement and supply for publication in Supply Chain Management Magazine. Who to contact Please send your application form with supporting documents to trust@cips.org.za AFRICA EMPOWERMENT TRUST CIPS Africa Broad Based Empowerment Trust Individual Bursary Application form 2015 Instructions: • Read carefully before completing, signing or submitting this form. • Ensure that this form is completed in full. • Note that this bursary cannot be used to pay for existing loans, debts or any other than; o One year membership fee (if you are an existing member) o One year membership and once off registration fee (to new members) o Course books o Examination registration o Invigilation fee (depending on the exam centre) Criteria: • Ensure that this form is duly signed. • Application forms with incomplete information will be disqualified. • Application forms with incorrect information will lead to your application being disqualified. Ensure that you meet the following: Attach ALL of the following documents REQUIRED: • • • • • • • • • • Completed Application form 2 page C.V A Valid South African ID or any other Supporting prove of Identification (depending on the Nationality) Matric Certificate 3 Months Bank Statement and payslip (if applicant is employed) If the applicant is unemployed, a sworn affidavit stating un-employment Parents or guardians 3 months bank statement (if employed) Should parents or guardian be unemployed, sworn affidavit stating unemployment If parents or guardians are deceased, kindly send a copy of the death certificate Motivation letter (No longer than 300 words) motivating why you should be considered for the grant NB: The following should be certified: • Matric Certificate • A Valid South African ID or any other Supporting prove of Identification (depending on the Nationality) • Death certificate (if applicable) Declaration: • I hereby, declare that all the information provided in this application form is complete and correct. • I hereby, acknowledge that if any of the information provided in this application form is found to be Incomplete and/or incorrect, my application • will be disqualified. NAME OF APPLICANT PARENT / LEGAL GUARDIAN DATE DATE SIGNATURE SIGNATURE AFRICA EMPOWERMENT TRUST Application Form - Youth Programme Personal Details NAME SURNAME GENDER M F AGE DATE OF BIRTH RACE NATIONALITY ID OR PASSPORT NUMBER CIPS MEMBERSHIP NUMBER (if applicable) CELL PHONE TEL NO EMAIL PHYSICAL ADDRESS POSTAL ADDRESS Finances Average monthly income: R Total monthly household income: R Total monthly household expenditure: R NB: Attach Parents or guardians bank statement Dependents Name: Relationship to you: Age: Occupation: Address: