FULL TIME STUDENTS BURSARIES - GAUTENG DEPARTMENT OF HEALTH
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GAUTENG DEPARTMENT OF HEALTH
FULL TIME STUDENTS
BURSARIES
Chief Directorate: Human Resources Development & Employee Health Wellness Programme:
Professional Development – Bursary Section
Who can apply:
All full-time students and Grade 12 leaners who are not employed by the Department, and have applied or are
already registered at a recognized Institution of Higher Learning in South Africa for the following courses:
MBChB, Pharmacy, Physiotherapy, Occupational Therapy, Speech Therapy, Language
& Pathology, Radiography, Emergency Medical Care, Clinical Engineering, Medical
Orthotics & Prosthetics
Applicants must be South African citizens, for all intents and purposes, are permanently residing in Gauteng
Province and coming from disadvantaged background.
Preference will be given to those who:
• Excel academically and / or demonstrate potential.
• Have not previously benefited from the Gauteng Department of Health’s Bursary Fund.
• Are not currently benefiting from any other bursary scheme.
• Gauteng permanent residence.
PLEASE NOTE: All successful applicants will be required to enter into contractual agreements with the
Gauteng Department of Health.
Contact Details:
Physical address Postal Address (preferably registered mail)
N0. 79 Fox Street Bursary Section
Cnr. Fox and Simmonds Private Bag X085
Johannesburg Marshalltown
2107 2107
E-mail: Aubrey.Ditshego@gauteng.gov.za • Cell: 061 165 9412
Website: www.health.gpg.gov.za
For more details on the advert please check the Department’s website and Newspapers.
BURSARY CLOSING DATE: 14 October 2016
Together, Moving Gauteng City Region Forward
Gauteng Department of Health
37 Sauer Street, Johannesburg
Private Bag X085, Marshalltown
2107
BURSARY APPLICATION FORM
Under Graduate studies – Full Time Applicants
Directions to applicants:
No late applications will be accepted after the closing date.
The application form must be completed in block letters.
Where applicable mark with X.
Only completed forms will be considered (no faxes or e-mails).
Applicants must comply with the check list of all supporting documents below to be considered for a
bursary.
ACCOMPANYING DOCUMENTS AND CHECK LIST (ALL COPIES MUST BE RECENTLY CETIFIED)
Copy of your Identity Document.
Copy of your Parents / Guardian Identity Document.
Copies of Identity Documents/Birth certificates of dependants.
Copy of your Grade 12 certificate.
Proof of registration at a University (for those that are registered).
Academic record (progress report) University.
Proof of income of parents / guardian (sworn affidavits for those without proof of income).
Proof of residence (utility bill registered in your parents/guardian name – e.g. electricity account).
Grade12 applicants must ensure that they provide the following documents in addition to the above:
Motivation why you should be awarded a bursary.
Letter from the manager at a Hospital/ health Facility where you have done voluntary work.
Copy of your mid – term grade 12 results.
Letter of acceptance/preliminary acceptance from the University.
Page 1 of 4PART A: PERSONAL DETAILS
Title: Surname: First Name:
Gender: Female Male Race: African Coloured Indian White
Disability Yes No If yes please specify:
Identity
Number
Nationality: Province:
Marital Status: _______________________ Home Language: _______________________
Residential Address: Postal Address:
____________________________________ _____________________________________
____________________________________ _____________________________________
____________________________________ _____________________________________
Postal code: __________________________ Postal code: ___________________________
Home Tel No.:_________________________ Other: _______________________________
Cell No.: _____________________________
E-mail: _____________________________________________________________________________
PART B: DEGREE INFORMATION
NAME OF THE DEGREE/DIPLOMA FOR WHICH THE BURSARY IS REQUIRED (e.g. MBCHB/Pharmacy/MOP):
For which year of study are you requesting the 1st 2nd 3rd 4th 5th 6th
bursary?
At which University are you registered / intending to register: ________________________________________
Student No.: _________________________________Year of Study: ___________________________________
Major subjects:
__________________________________________________________________________________________
________________________________________________________________________ _________________
Page 2 of 4PART C: HIGH SCHOOL DETAILS
Last School Year: ______________ Name of School: _______________________________________________
Highest grade passed: ___________________________
Subjects Passed Symbols / Levels
PART D: INSTITUTION OF HIGHER LEARNING FINANCIAL STATUS
Are you currently or have you been a recipient of a bursary (Government/Private):
Yes No
If yes- Name of the bursary: _________________________________________________________
When did the bursary obligation expire: _______________________________________________
Do you / have you received a study loan
Yes No
If yes- Name of the loan and Institution: ________________________________________________
Value of the loan: ______________________________________________________________
Contract period of the loan: _____________________________________________
PART E: PARENT / GUARDIAN DETAILS
Name and Surname: ____________________________________________________________________________
Home Tel No.: ______________________________ Work Tel No.: _________________________________
Cell No.: ___________________________________ E-mail: _______________________________________
Address: ______________________________________________________________________________________
______________________________________________________________________________________
___________________________________________________________ Postal code: _________________
Relationship: ___________________________________________________________________________________
Page 3 of 4PART F: PARENT / GUARDIAN FINANCIAL STATUS
Mother Job Title: ________________________________ Monthly income: R_____________________________
Father Job Title: _________________________________ Monthly income: R_____________________________
Guardian Job Title: _______________________________ Monthly income: R_____________________________
Total Parents / Guardian combined income per annum: R____________________________________________
Number of Dependants: Not Studying: _____ At Tertiary: ______ At School: ______
PART G: DECLARATION
I declare that the above information provided is correct. In the event that I am provided with a bursary I
will abide by the regulation of the Gauteng Department of Health’s Bursary Scheme.
Applicants signature: _____________________________ Date: ___________________________
Parent / Guardian signature: _______________________ Date: ___________________________
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