WARWICK UNDERGRADUATE SANCTUARY SCHOLARSHIPS (ARTICLE 26) WORKING WITH THE HELENA KENNEDY FOUNDATION APPLICATION FORM 2018-19 Section 1 Personal Details Title: Mr/ Mrs/ Miss/ Other First Names: Surname or Family Name: Date of Birth: Age at 1 September 2018: University ID Number: UCAS ID Number: (Only students who have accepted an offer of a place at Warwick will be considered for an award) Contact Email Address: (All correspondence relating to your application will be sent to this address) Undergraduate course applied for at Warwick: Length of course (years): Section 2 Educational History Have you previously studied for an undergraduate degree or other Higher Education qualification? Yes No If yes, please give details: Name and address of the school/ college you most recently attended:
Section 3 Eligibility for Sanctuary Scholarship Date you arrived in the UK: Your country of origin: What date did you apply for asylum in the UK? What decision have you received on your application for asylum? (Please provide evidence) Please select the category which best describes your current immigration status in the UK Mark only one available option a) I have been granted refugee status AND Indefinite Leave to Remain (ILR) b) I have been granted five years limited leave as a refugee, and intent to apply for Indefinite Leave to Remain (IRL) c) I have been granted Humanitarian Protection (HP) AND Indefinite Leave to Remain (ILR) d) I have been granted Humanitarian Protection (HP) for an initial period of five years limited leave, and intend to apply for Indefinite Leave to Remain (IRL) e) I have been granted Discretionary Leave to Remain (DLR) OR Limited Leave to Remain f) I am awaiting a decision on my application for asylum claim OR I am in the appeals process g) My application for refugee status has been finally determined as refused OR I am submitting and fresh claim or applying for judicial review h) I am the family member of one of the above and my application is dependent on theirs/ my leave has been granted in line with theirs If you have selected option H above, please indicate which or the categories A to H applied to your family member. If you have not selected option H above then please write Not applicable
Section 4 Personal Statement In no more than 750 words, please tell us why we should choose you as a scholar. Your statement should include: Details of your personal and family circumstances and the barriers you may have faced in continuing your education with particular reference to your current status in the UK. You do not need to give details of the events that led you to seek asylum unless you wish to do so. Your ambitions for the future, why you have chosen your course of study and how the Sanctuary Scholarship will help you to achieve your goals. Details of you and your family s current financial circumstances. Any additional support you feel you may need to succeed at university. (please continue on a separate sheet if necessary)
Section 5 Referee Statement The Referee s Supporting Statement is an important part of the selection process. Ideally, your referee should know you in a professional capacity, such as a social worker, doctor, solicitor or welfare adviser. The referee statement must be on letter headed paper and be signed and dated by your referee. Please attach a statement of no more than 750 words to cover the following information: What are the applicant s personal and financial circumstances and what barriers have they overcome to continue their education? How well suited is the applicant to the higher education course they plan to take and how realistic are the student s ambitions? What contribution, to your knowledge, has the applicant made to his or her school/college and local community. Is there any other information that you consider is relevant to the student s application? How do you think the student would benefit from the support offered by the Warwick University Sanctuary Scholarship? First Name: Surname or family name: Relationship to applicant: How long have you known the applicant? Name of organisation you work for: Role in organisation: Address: REFEREE DETAILS Telephone number: Email address:
Section 6 - Declaration The information I have given on this form is accurate to the best of my knowledge and belief. I have enclosed evidence of the status of my asylum application Data Protection: Please read carefully and tick the boxes as appropriate The University of Warwick will process your personal data provided in this application form for the purpose(s) of processing your application and assessing your eligibility for the Undergraduate Sanctuary (Article 26) Scholarship. In order to process your personal data in compliance with the legal requirements of the General Data Protection Regulations you must provide your explicit consent by ticking the box below. Failure to tick this box means we are unable to process your Sanctuary Scholarship application further. I consent for you to process my personal data for the purposes stated above. The University will need to process your sensitive personal data provided in this form for the purposes of processing your application and assessing your eligibility for the Undergraduate Sanctuary (Article 26) Scholarship. I explicitly consent to the processing of my sensitive personal data for the above purposes. I do not explicitly consent to the processing of my sensitive personal data for the above purposes and understand that my application cannot be processed. Your personal data will not be shared or disclosed to any third parties external to the University of Warwick. Your personal data will not be transferred outside of the EEA and will be kept securely by the University of Warwick and will be retained for as long as the 2018-2019 academic year plus six years. The University of Warwick is the Data Controller of this information and is committed to protecting the rights of individuals in line with Data Protection Legislation. Please visit the Information Commissioner s Office s for further information in relation to your rights and the University s Data Protection webpage for further information about how the University processes your personal data. The University s Data Protection Officer, A Bajaj, can be contacted through mailto: infocompliance@warwick.ac.uk and any requests or complaints should be made in writing to the University s Data Protection Officer. Signed (applicant): Date: Completed forms should be returned to: Student Funding Office, Senate House, University of Warwick, Coventry, CV4 7AL. Tel: (024) 7615 0096 Email: studentfunding@warwick.ac.uk The closing date for applications is Friday 29 June 2018