Travel Bursary Application
West Midlands Consortium BFI Film Academy
Select your Film Academy:
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FA#1 Sandwell, Walsall & Birmingham - Rural Media
FA#2 Herefordshire & Worcestershire - Rural Media
FA#3 Shropshire, Telford & Wrekin - MediaActive
FA#4 Stoke & Staffordshire - Rural Media
Your Contact Details
Please complete these details
Name
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First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
REASON FOR BURSARY: Are you or your parents in receipt of the following?
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Universal Credit
Council Tax Benefit
Free School Meals
Support under part VI of Immigration & Asylum Act 1999
Not in receipt of the above benefits. (Please explain below)
If NOT in receipt of the above benefits, please explain why you require a bursary below:
ESTIMATED COST
If you are claiming a travel bursary
Number of course sessions:
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Mode of transportation
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Estimated costs of a return journey?
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Total estimated cost?
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Childcare Bursary
If you are claiming a childcare bursary
Number of course sessions
Estimated cost per session
Total estimated cost
If you care claiming a bursary for any other reason, please describe the reason:
Total estimated cost of Travel & Childcare.
If claiming for only one, please enter that.
DECLARATION
I can confirm that, to the best of my knowledge, the information provided on this form is correct. The BFI reserve the right to suspend or withdraw payments in the event of unsatisfactory attendance.
Participant Signature
*
Submit
Keep ALL your Travel Recipes!
This form is sent to Rural Media's BFI Lead Dan Haworth-Salter and to your course leader for approval. If you require any further assistance, please contact your course leader. Once approved, you'll need to submit AN EXPENSE CLAIM form WITH RECIPES to claim your travel back.
Should be Empty: