HCDT BURSARY FORM FOR 2024/2025 ACADEMIC YEAR – Tertiary – Ikuru Host Community Development Trust

Undergraduate Bursary Form

Applicant's Information

Name of student (surname first) *

Gender *

Phone *

Email address *

Select bursary category

Name of school *0 / 255

Location of school (LGA/State) *0 / 255

Faculty of study *0 / 255

Course/Department *0 / 255

Year of admission *0 / 255

Have you been a beneficiary of this bursary scheme? *

Current level0 / 255

Expected year of gradution0 / 255

Compulsory Requirements for Payment

Attach genuine photocopies of the underlisted documents to your returned form

Letter of admission

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Admission acceptance letter *Upload your admission acceptance letter

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Proof of payment for admission acceptance fee

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Last academic session result *

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School fees receipt *Upload your last school fees receipt

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Current student school identity card

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Parents' Information

Name of father *

Maiden Name of mother and family name of Mother, if father is not from lkuru-Town

Name of father's family *0 / 255

Is your father a native of Ikuru Town? *

Name of mother's family *0 / 255

Is your mother a native of Ikuru Town? *

Account name *0 / 255

Account number *0 / 10

Bank name

Consent *

I hereby declare that the above information given by me are correct; any false declaration stated herein will lead to the disqualification of my application.

Confirmation of attestation *Upload a letter written and signed by a Chief or an Elder above 60 years of age from Applicant’s Family or from Ikuru Town Community. If your form is not duly signed, you stand DISQUALIFIED.

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Your passport photo *

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Undergraduate Bursary Form

Applicant's Information

Compulsory Requirements for Payment

Attach genuine photocopies of the underlisted documents to your returned form

Parents' Information

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