Access Scholarship Financial Declaration Form Access Scholarship Financial Declaration Form For Students with GuardiansFor Self Employed Students 1. Parent or Guardian Details Parent/Guardian name: Parent’s Profession: Mobile: E-mail: 2. Student Current Academic Status Are you enrolled in school/university this year? YesNo If yes, please state name of school or university If not, please indicate what you have been doing since your school graduation 3. Financial Status Information 3.1 Income 3.1.1 Annual Gross Salary of Applicant or Guardian AED / year 3.1.2 Other income from family members or properties AED / year 3.1.3 Financial Aid Donor Name AED / year 3.2 Educational Expense for Dependents List all family members who are dependent on the income mentioned in (3.1) above. Do not include employed members already mentioned in (3.1). Start with university/college/school members. # Name Age University /School Tuition Fees [field_group income-dependents id="income-dependents" tabindex:1] . AED / year [/field_group] 3.3 Housing and Living Expenses 3.1.1 Rent expenses AED / year 3.1.2 Living expenses for the family and dependents AED / year 3.1.3 If you or your family is in debt, write the amount. AED / year 3.1.4 How much do you or your family pay for this debt? AED / year 4. Special Circumstances If there are special circumstances which cause unusual financial burden (such as disabled family members, etc.), please give details below. Supporting documentation must be provided. 5. Declaration of Integrity I certify that the answers to all questions and statements provided are complete and accurate.I authorize JU to investigate all statements contained herein.I further understand that any misrepresentation or purposeful omission will invalidate this application and may disqualify me from future scholarship consideration.I also understand that the scholarship committee reserves the right to pass its findings regarding such misrepresentation and omission to the office of the registrar for inclusion in the student’s Permanent Record. 6. Supporting Documents Applicant must submit the following documents with this form: Valid salary certificate of applicant or guardian ( 1.3.3) . Documents for other incomes mentioned in the Financial Status (3.1.2) i.e. salary certificate for non dependent, etc. Documents for Financial Aids mentioned in the Financial Status (3.1.3). A copy of the rental contract for accommodation. Bank statement of applicant or guardian for a period of 3 months from the date of application. Water and electricity bill for a period of one month from the date of application. Documents regarding loans mentioned in the Financial Status (3.3.3) Applicants with guardian must submit certificates verifying education tuition fees for all family members (3.2). 7. Signature Guardian’s Signature: Date: Day / Month / Year Applicant’s Signature: Date: Day / Month / Year
