RCSA Trust Application RCSA Trust Application Personal Details Name of Applicant * Name of Applicant First First Last Last Course * Course Department Department Course Course Year of Study Year of Study on behalf of (if applicable) Address for Correspondence * Telephone Number (mobile) Telephone Number (day) Telephone Number (evening) Email Address * Details of Application Indicate under which clause (see note 5) you are applying * Explain how the Trust could help you achieve your objectives; give a concise summary below and prepare supporting papers. Ensure that these include full details of who you are, what you are studying and why you need funding. If you are applying on behalf of a group (e.g. an expedition), the Trust needs details (name, department, course and year) of each group member (not just those seeking assistance). Failure to provide sufficient detail will result in consideration of your petition being deferred until such detailed information is provided. If you are unsure what you should tell us, please ask for advice (see note 10). Details * State how much money in total you need to achieve your objectives, and how much you have raised from other sources. A full budget is required (see note 6). Total required * Total raised * Please state to whom (or title of the bank account to which) cheque should be payable if your petition is successful (see note 8) * Referee Give the name and contact details of a person (such as a member of the academic staff of the College) who is aware of the circumstances under which you are applying and who supports this application. The Referee will be required to attend the meeting at which the application is considered unless otherwise advised (see note 4). In the case of applications for the Toms Fund, the referee would normally be the Chair of the Motor Club. Name * Name Title Title First First Last Last Address * Telephone Number (mobile) Telephone Number (day) Telephone Number (evening) Email Address * Capacity in which acting as Referee (e.g. Personal Tutor) * Declaration Declaration 1 * I confirm that the information provided is accurate at time of writing. Declaration 2 * I confirm I have discussed this application with the referee. Declaration 3 * I confirm the referee is willing and available to attend the Trust meeting if requested. Declaration 4 * I confirm the referee has a copy of all supporting documentation accompanying this form. Submit If you are human, leave this field blank.
