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Education, Leisure and Housing

Kirkwood Bequest: Form G5b

This application should not be submitted unless you received approval for Form G5a.

Applicant Details
Name:
Home Address:
Course Name and Level:
College / University:
Forthcoming Attendance Dates:From:                                                     To:
Duration of Course (years):
Current Year (e.g. first, second):

Supporting Documents

First Year of Funding:

  • Copy of your letter/email of acceptance from your college or University.

Continued Funding:

  • Confirmation that you successfully completed the previous year of study.
  • Confirmation of your acceptance for continued study on the approved course.

Declaration

I certify that all the information provided on this form is correct and complete to the best of my knowledge and I will notify Education, Leisure and Housing immediately of any change to my circumstances which may have an impact on my entitlement. I understand that providing false or misleading information may result in the withdrawal of support and I may have to pay back any amount received which I was not entitled to. I also give permission for Orkney Islands Council to receive information related to my attendance, progress and conduct from my college/university for assessing my eligibility for payments.

Orkney Islands Council are committed to protecting and safeguarding your privacy. We will only use the information that we collect about you lawfully in accordance with the General Data Protection Regulations. The information relating to this application will be retained for the period stated in the Council’s Retention and Disposal Schedule. For more information about how we process information, please contact us or visit: https://www.orkney.gov.uk/Online-Services/privacy.htm

By signing this declaration you confirm that you have read and agree to the above terms.

Applicant Signature:Date:

This completed application form must be submitted by 5 October to: Kirkwood Bequest, Education, Leisure and Housing, Orkney Islands Council, Kirkwall.

IMAGE: The page is a one-page Kirkwood Bequest Form G5b application from Education, Leisure and Housing. It contains blank applicant-detail fields, supporting-document requirements for first-year and continued funding, a declaration and privacy notice, signature and date fields, and submission instructions stating that the completed form must be submitted by 5 October to Kirkwood Bequest, Education, Leisure and Housing, Orkney Islands Council, Kirkwall.