SMART Scholarship Application Form

This form should be completed by the applicant, parent(s)/carer(s) and referee.

Please read our Scholarship Information document on our website BEFORE completing the form.

ALL applications require a referee. Please contact your referee to ensure you have their reference and contact details BEFORE completing this form as this will need to be included below.

If you have any questions, please contact funding@suffolksmart.org.

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Deadline for 24/25 Academic Year Scholarship Applications: 19th June 2024

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The information you provide will stay confidential, and be stored securely. It will only be used for monitoring purposes and will not be disclosed to any third party except where we are required to by law; where you have provided your explicit consent for us to pass data to a named third party (for example, Suffolk Youth Music); or a third party is purely processing data on our behalf.
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Email address to be used for correspondence regarding application:
This should be the parent/carer if applicant is under 16.
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Applicant's Information
Applicant's Name *
Applicant's Date of Birth *
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Applicant's Home Address, including post code *
Applicant's Nationality *
Applicant's School/College
Name of Applicant's School/College *
Address of Applicant's School/College *
What school year will the Applicant be starting in September 2023? *
Is the Applicant's school/college a private (fee-paying) or state school? *
If you answered "Private", please give details of the amount of school fees (if applicable) including the names and amounts of any fee reductions (e.g. bursary awards or scholarships)
Other Funding

Is the Applicant currently in receipt of support from any other funding body or external source?

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If yes, please provide details.

Do you intend to apply or have any pending funding applications for support for the 2023/24 academic year?

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If yes, please provide details.
Reasons for Applying

To be completed by the applicant.

This is our chance to get to know you. Please let us know why you would like a scholarship and provide any other information you feel is relevant to your application.

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Family Details
For anyone with parental responsibility for the applicant.
Please state marital status e.g. single, married, civil partnership, cohabiting, divorced, separated, widowed.
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Parent/Carer 1
Name of Parent/Carer
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Please state type of employment e.g. employed, self-employed, unemployed, retired, other
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Profession *
Name and address of employer/business *
If you are the Director of the company, please state the proportion of each class of shares you hold
Parent/Carer 2
Name of Parent/Carer
Please state type of employment e.g. employed, self-employed, unemployed, retired, other
Profession
Name and address of employer/business
If you are the Director of the company, please state the proportion of each class of shares you hold
If applicable, please provide the above details for anyone else with parental responsibility for the applicant.
Annual Gross Income

Please answer the questions below ensuring all figures show the predicted annual gross income (before any deductions for tax, National Insurance, etc.) for the tax year 2022/23. 

You may be asked to provide photocopies of documentation supporting the figures that you complete below. We may require copies of P60 or other tax return documentation and, if you are self-employed, a copy of your most recent IR-approved accounts must be provided.

For Parent/Carer 1
Income from employment and self-employment (please state if known or predicted)
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Occupational pensions received
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Social security benefits
 *
Property income (gross ‘profit’ after deduction of allowable expenses)
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Bank/Building Society Interest (gross)
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Other Investment Income (gross)
 *
Child Support or Maintenance Allowance received
 *
Any other sources of income (please specify)
 *
Mandatory deductions (e.g. income tax, national insurance, pension contributions, student loan repayment, child support/maintenance, mandatory debt repayments, etc.)
 *
Total income after deductions *
For Parent/Carer 2
Income from employment and self-employment (please state if known or predicted)
Occupational pensions received
Social security benefits
Property income (gross ‘profit’ after deduction of allowable expenses)
Bank/Building Society Interest (gross)
Other Investment Income (gross)
Any other sources of income (please specify)
Mandatory deductions (e.g. income tax, national insurance, pension contributions, student loan repayment, child support/maintenance, mandatory debt repayments, etc.)
Total income after deductions
Dependent Children and/or Relatives
Please list all children and/or relatives who are wholly or mainly dependent on the parents/carers, including the child for whom this application is made.

Please provide: Name, date of birth, relationship to parents/carers of applicant
Additional Financial Information
If you would like to give further details of relevant financial circumstances or other information relevant to the support of your application, please do so below.
Are the Applicant’s parents/carers entitled to any of the following? (Please tick ALL that apply. Evidence may be required to verify this information.)
Referee's Information
Please note that the referee may not be the applicant's parent/carer.
Referee's Name *
Referee's Job Title *
Referee's Organisation and Address *
Referee's Email Address *
Referee's Relationship to Applicant *
Reference for Applicant
Please let us know why the applicant is deserving of a scholarship.
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Publicity of Grants

SMART would like to be able to publicise the impact of its funding to encourage donations and further applications.

SMART wishes to take, use and store photographs or films of children and young people under the age of 18. However, we will only do this if we have obtained written permission from a parent/guardian or from a young person aged 16 years and upwards.

We will process and store and photographs or film of your child safely and securely.

We appreciate that not everyone will want to be photographed or filmed and we will ensure that this does not excluded anyone from participating in our events or activities.

Please see below to complete your details and sign if you give us your permission.

If you wish to withdraw your permissions at any future point or if you have any questions, then please contact admin@suffolksmart.org.

Purpose for taking/using/storing photographs/film: To promote SMART's grants and impact. Photographs/film may be published in these ways: Website, social media, newsletters, marketing/publicity materials, funding applications, charity documentation and reports. Photographs or film will be stored: Until consent is withdrawn.

I give my permission for the above-named child or young person to be photographed by SMART as outlined in this form.

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I give my permission for the above-named child or young person to be filmed by SMART as outlined in this form.

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I give permission for the above-named child or young person's name and age to be published with the photograph/film.

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I understand that by signing this form that SMART is obliged to keep a copy of it to comply with our wishes and data protection law.
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Parent/Carer's Name (or applicant if aged 16 or over) *
Parent/Carer's Email Address (or applicant if aged 16 or over) *
Parent/Carer's relationship to applicant 
(If applicant is aged 16 or over, state "Applicant")
 *
Equal Opportunities Monitoring
We acknowledge that diversity enhances the arts sector and drives innovation. We aim to address the underrepresentation of certain communities within the arts through our grant making. We are committed to being open and honest with our members, to work with the communities we represent to improve, and to embed diversity and inclusion in the heart of all that we do.

We would be grateful if you complete our Equal Opportunities Monitoring Form: https://forms.gle/4gjHdyDMg8A48YPh7

This form helps SMART to ensure that our opportunities are accessible to everyone, regardless of background.

The form should be completed by the applicant (not the applicant's parent/carer/referee).

The information you provide will stay confidential, and be stored securely. It will only be used for monitoring purposes and will not be disclosed to any third party except where we are required to by law; where you have provided your explicit consent for us to pass data to a named third party (for example, Suffolk Youth Music); or a third party is purely processing data on our behalf.
Privacy Statement

SMART and its Trustees are committed to protecting the privacy and security of your personal information. Here are some key facts about how and why we collect, hold, use and protect your personal information.

Personal information (or data) is information that can be used to identify you, such as your name.  SMART holds and processes your personal data to administer this scholarship application and comply with the law.  We will collect and hold only personal data which is necessary to allow us to do this, such as the name and contact details of the scholarship applicant and referee.  SMART requires data about the individual scholarship applicant to be anonymised, in particular because some of the data we collect may be classed as ‘sensitive data’, such as information you tell us about any special educational needs or financial circumstances.

Your information may be shared with third parties where we are required by law to share your data, where you have provided your explicit consent for us to pass data to a named third party (for example Suffolk Youth Music), or a third party is purely processing data on our behalf.  

For more information about how we use your personal data and your rights regarding that data see our Privacy Policy at suffolksmart.org.  If you have any further questions, please email admin@suffolksmart.org.
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