Student application form Application for Student Busary "*" indicates required fields 1Personal Particulars2Academic Details3Additional Information PhoneThis field is for validation purposes and should be left unchanged.Name* First Last Email Gender* Male Female Contact Number*Alternative NumberAddress* 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 Place of Origin* Rural Township Urban/Suburb Annual Household Income*0 - R200 000R200 001 - R300 000R300 001 - R400 000R400 000 +Please submit proof thereof. Name Of School 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 Year of Matriculation(this can be a future date for high school students applying in grade 11)Subject 1*First LanguageSecond Additional LanguageThird Additional LanguagePhysical ScienceLife ScienceMathematicsMathematical LiteracyComputer Applications TechnologyInformation TechnologyAccountingBusiness StudiesEconomicsGeographyHistoryLife OrientationReligion StudiesConsumer StudiesHospitality Studies (previously Home Economics)TourismDesignDance StudiesDramatics ArtsMusicVisual ArtsMechanical TechnologyElectrical TechnologyEngineering Graphics & DesignCivil TechonologyAgriculture ScienceAgriculture TechnologyAgriculture Management Practices% Score*Please enter a number from 0 to 100.Subject 2*First LanguageSecond Additional LanguageThird Additional LanguagePhysical ScienceLife ScienceMathematicsMathematical LiteracyComputer Applications TechnologyInformation TechnologyAccountingBusiness StudiesEconomicsGeographyHistoryLife OrientationReligion StudiesConsumer StudiesHospitality Studies (previously Home Economics)TourismDesignDance StudiesDramatics ArtsMusicVisual ArtsMechanical TechnologyElectrical TechnologyEngineering Graphics & DesignCivil TechonologyAgriculture ScienceAgriculture TechnologyAgriculture Management Practices% Score*Please enter a number from 0 to 100.Subject 3*First LanguageSecond Additional LanguageThird Additional LanguagePhysical ScienceLife ScienceMathematicsMathematical LiteracyComputer Applications TechnologyInformation TechnologyAccountingBusiness StudiesEconomicsGeographyHistoryLife OrientationReligion StudiesConsumer StudiesHospitality Studies (previously Home Economics)TourismDesignDance StudiesDramatics ArtsMusicVisual ArtsMechanical TechnologyElectrical TechnologyEngineering Graphics & DesignCivil TechonologyAgriculture ScienceAgriculture TechnologyAgriculture Management Practices% Score*Please enter a number from 0 to 100.Subject 4*First LanguageSecond Additional LanguageThird Additional LanguagePhysical ScienceLife ScienceMathematicsMathematical LiteracyComputer Applications TechnologyInformation TechnologyAccountingBusiness StudiesEconomicsGeographyHistoryLife OrientationReligion StudiesConsumer StudiesHospitality Studies (previously Home Economics)TourismDesignDance StudiesDramatics ArtsMusicVisual ArtsMechanical TechnologyElectrical TechnologyEngineering Graphics & DesignCivil TechonologyAgriculture ScienceAgriculture TechnologyAgriculture Management Practices% Score*Please enter a number from 0 to 100.Subject 5*First LanguageSecond Additional LanguageThird Additional LanguagePhysical ScienceLife ScienceMathematicsMathematical LiteracyComputer Applications TechnologyInformation TechnologyAccountingBusiness StudiesEconomicsGeographyHistoryLife OrientationReligion StudiesConsumer StudiesHospitality Studies (previously Home Economics)TourismDesignDance StudiesDramatics ArtsMusicVisual ArtsMechanical TechnologyElectrical TechnologyEngineering Graphics & DesignCivil TechonologyAgriculture ScienceAgriculture TechnologyAgriculture Management Practices% ScorePlease enter a number from 0 to 100.Subject 6*First LanguageSecond Additional LanguageThird Additional LanguagePhysical ScienceLife ScienceMathematicsMathematical LiteracyComputer Applications TechnologyInformation TechnologyAccountingBusiness StudiesEconomicsGeographyHistoryLife OrientationReligion StudiesConsumer StudiesHospitality Studies (previously Home Economics)TourismDesignDance StudiesDramatics ArtsMusicVisual ArtsMechanical TechnologyElectrical TechnologyEngineering Graphics & DesignCivil TechonologyAgriculture ScienceAgriculture TechnologyAgriculture Management Practices% Score*Please enter a number from 0 to 100.Subject 7*First LanguageSecond Additional LanguageThird Additional LanguagePhysical ScienceLife ScienceMathematicsMathematical LiteracyComputer Applications TechnologyInformation TechnologyAccountingBusiness StudiesEconomicsGeographyHistoryLife OrientationReligion StudiesConsumer StudiesHospitality Studies (previously Home Economics)TourismDesignDance StudiesDramatics ArtsMusicVisual ArtsMechanical TechnologyElectrical TechnologyEngineering Graphics & DesignCivil TechonologyAgriculture ScienceAgriculture TechnologyAgriculture Management Practices% Score*Please enter a number from 0 to 100.Subject 8First LanguageSecond Additional LanguageThird Additional LanguagePhysical ScienceLife ScienceMathematicsMathematical LiteracyComputer Applications TechnologyInformation TechnologyAccountingBusiness StudiesEconomicsGeographyHistoryLife OrientationReligion StudiesConsumer StudiesHospitality Studies (previously Home Economics)TourismDesignDance StudiesDramatics ArtsMusicVisual ArtsMechanical TechnologyElectrical TechnologyEngineering Graphics & DesignCivil TechonologyAgriculture ScienceAgriculture TechnologyAgriculture Management Practices% ScorePlease enter a number from 0 to 100.Subject 9First LanguageSecond Additional LanguageThird Additional LanguagePhysical ScienceLife ScienceMathematicsMathematical LiteracyComputer Applications TechnologyInformation TechnologyAccountingBusiness StudiesEconomicsGeographyHistoryLife OrientationReligion StudiesConsumer StudiesHospitality Studies (previously Home Economics)TourismDesignDance StudiesDramatics ArtsMusicVisual ArtsMechanical TechnologyElectrical TechnologyEngineering Graphics & DesignCivil TechonologyAgriculture ScienceAgriculture TechnologyAgriculture Management Practices% ScorePlease enter a number from 0 to 100.Latest Aggregate ScorePlease enter a number from 0 to 100.Qualification For Which Bursary is Required* National Diploma Degree Other Awards/BursariesCareer IntentionsWhat career do you intend to follow? Give reasons for your choiceProfessional and Social/Cultural ActivitiesGive particulars of membership and positions heldSport/Leisure/Interests/HobbiesGive full particulars of leadership positions held, captancies etcAny Other InformationThat may affect your application Where did you first hear about the Upstream Training Trust?Do you have any relatives working for the Pertroleum Agency SA?If yes, who and how are you related?Guardian/Parent Name Guardian/Parent Contact NumberUpload Files Drop files here or Select files Max. file size: 32 MB. Load Motivational Letters, Academic Results, Printed Application Form, Proof of Annual Household Income Here
