BLF – Scholarship Form Buckswood Legacy Fund -Application Form Please use the application form below to apply for Scholarships, Bursaries and the School Director’s Award. Section 1Applicant DetailsStudent Name First Last DOB ( Date of Birth) DD slash MM slash YYYY Year Group Applying ForCurrent SchoolHome Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Parent Email Is the student currently at Buckswood? Yes No Section 2Award ApplicationPlease tick all awards (and or) Scholarship discipline(s) you wish to apply for (more than one can be selected). Scholarship and Options Scholarship (Discipline-based award for excellence. Not means-tested.) Select Scholarship Option(s) Academic Sport Music Art All-Rounder Other Award Options Bursary (Means-tested financial assistance based on household income) School Director’s Award Sibling Concession (if student has sibling at the school, this is applied to one student) Armed Forces Concession (student must have parent/s currently serving in UK Armed Forces) Staff Concession (student must have family member employed by the school) Section 3Supporting InformationFor Scholarship Applications (please complete if applying for a scholarship)Please describe the student's achievements, awards, or recognitions in the chosen discipline(s):Please explain how the student will contribute to Buckswood School's community through this discipline(s):Attach supporting evidence in the dropbox at the end of this form such as: Certificates, portfolios, videos, references, etc. For Bursary Applications (please complete if applying for a Bursary)Total Household Income (Gross)(Attach supporting evidence in the dropbox at the end of this form)Main Expenditure Items (e.g., mortgage, loans, school fees for other children):Assets (Property, savings, investments, etc.):Please describe how your family can contribute positively to the Buckswood community (e.g., talks, work experience, sponsorships):Attach the follow documents using the dropbox at the end of this form: P60 and latest payslip Self-employment accounts (if applicable) Tax assessments Bank statements (last 2 months) Evidence of benefits, pensions, rental income, etc. For School Director’s Award Applications (Complete if applying for this award)Please explain why you are applying for the School Director's Award and why your case is exceptional:For Sibling concessionPlease name sibling currently attending the schoolFor Armed forces concessionPlease provide evidence of role in the UK armed forcesYou can attach evidence in the dropbox at the end of the form.For Staff concessionPlease provide details of current employeeSection 4Supporting DocumentsPlease attach all supporting evidence here(Required) Drop files here or Select files Max. file size: 512 MB. Please reach out to Buckswood UK Admissions team in case of any questions. Email: future@buckswood.co.uk Subject: Legacy Fund Application – [Student Name] For enquiries, please contact: achieve@buckswood.co.uk Section 5Please confirm all fields(Required) I/We confirm that the information provided is accurate and complete to the best of our knowledge. I/We understand that awards are subject to ongoing review and may be adjusted or withdrawn if criteria are not met. I/We understand that awards are made at the school’s discretion. /We agree to maintain confidentiality regarding any award received. I/We agree to submit all required supporting documentation with this application. Parent/Guardian 1 Name: Signature:(Required)Date(Required) MM slash DD slash YYYY Parent/Guardian 2 Name: Signature:Date MM slash DD slash YYYY
