1) I confirm that I have applied for the SUSI grant and am awaiting the approval and/or payment of same.
2) I confirm that I have acknowledgement of my application to SUSI and I will submit a copy of this when requested:
3) I wish to apply for assistance for (please tick all that apply):
4) From the categories of Living Expenses listed below, please indicate the purpose for which you are applying for assistance (you may choose only 2 categories).
5) Please indicate the number of children (Please enter 0 if not applicable):
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7) Are you a participant in or in receipt of any of the following (tick all that apply)
8) If you are applying for assistance for any of the following reasons, please tick the relevant box and provide information below on the extent of the problem(s) encountered under question 9 (100 word limit)
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10) Please indicate living arrangements
11) If you are dependent on family support , please indicate the number of your siblings in fulltime education:
12) Please enter your income from September - May (9 months) in the relevant boxes (NOTE: Please only enter income in respect of yourself e.g. OPFS received by you, minus amount added for children): :
13) What is your current fee arrangement (tick all that apply)?
14) If your application relates to a fee issue please provide the following information:
15) Are you requesting that your fees be paid in more than 2 installments?
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19) All the information given is true, complete and accurate in every particular and assistance from other sources has not been received for the stated purpose/service, which is the subject of this application. If the information given is found to be untrue your application in the current year will be rendered ineligible and you may not reapply.
By clicking yes, you are confirming agreement with the above statement
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21) Are you registered as a full-time or part-time student (please tick below):
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