Residential and Discretionary Learner Support Fund Application Form 2019/20

I declare that the information given in this application form is, to the best of my knowledge, information and belief, true in all aspects.I understand that if I knowingly make a false statement or provide false information, I may render myself liable for prosecution.

I authorise Reaseheath College or a representative to check any information I have given in this application.

I will inform Reaseheath College immediately if I withdraw from or stop attending my course and I understand that I may have to repay part or all of the residential/lodgings and associated costs if I withdraw from my course.

I undertake to repay any sums overpaid to me if required to do so.

I am applying for support funds as my main source of funding for my costs. I will tell Reaseheath College if I receive help with these costs from other sources.

I also undertake to declare any funding I receive if I apply for help from other sources.

I agree that the information provided in this form may be used by the Department for education and skills and its agents in connection with management, evaluation and auditing purposes.

This information I have given on this form is complete and accurate to the best of my knowledge and belief.

I will inform you immediately of any change in my circumstances which might affect this application for support.

I agree to supply further information you may ask for. I understand that if I give false information, or fail to give complete information, I may be prosecuted.