DISABILITY FUND APPLICATION FORM 2009-2010

WHO CAN APPLY?

The Students’ Union Disabilities Fund is open to students registered at the

LSE. Unfortunately we do not accept applications from private individuals
(non-registered students).

PURPOSE OF FUND

The fund is intended to assist students who incur extra study related
additional costs as a result of disability. It is includes the costs of some
equipment and specialist support care.

PLEASE NOTE THAT THE MAXIMUM AWARD IS £1500 PER ACADEMIC

YEAR PER STUDENT.

USE OF FUNDS AWARDED

Please note that the funds awarded are given on the basis that it will be used
solely for the purpose for which it was given. Should the Student’s Union
become aware that the funds are used for any other purpose we will
seek to recover the full sum.

CONFIDENTIALITY
.
The application is assessed by staff of the Advice centre and, if subjected to
reconsideration, by the reconsideration panel only. The information that you
provide on the application form and during the interview will be treated as
confidential and not be shared with any other persons unless you give us
permission to discuss the application with a relevant 3rd party, where
necessary

The SU often needs to share information about your case with the LSE
Disabilities Office. Do you have any objection to your information being
shared with the Disabilities office? Yes / No

Please note that answering no does not affect the outcome of your
application.

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WHAT YOU HAVE TO DO

Complete the application form giving details of all additional study related
costs you have as a result of disability. These may include, for example, taxi
costs, paying readers, dyslexia assessments or adapted equipment.

You will be required to provide documentary evidence to support your

application which could be in the form of the Individual Student Support
Agreement agreed with the Adviser to Disabled students and/or any receipts
or quotes relating to your costs. If you are unsure what to provide this can be
discussed with an Advice Centre Adviser.

The following documents must be returned in person to the ACC Office, Room
E297, East Building;

1. Completed Form
2. ISSA (if applicable)
3. Copy of current certificate of registration
4. Additional supporting documents

Where there are exceptional reasons why an applicant cannot return the
documents in person, an Advisor may give permission for an online
application to be submitted.

WHAT HAPPENS AFTER APPLICATION IS SUBMITTED

When the application and supporting documents are submitted, an

appointment will be agreed for you to be interviewed by an Adviser.

The interview will take the form of a short discussion with an adviser.
Information shared at the meeting is kept entirely confidential. If you feel
uncomfortable about discussing your situation at interview please talk to
an adviser at the Advice Centre about your concerns.

If you need to change your interview time please let us know as soon as
possible. (Room E297 or Tel: 020-7955-7145 or E-mail: SU.Advice-
Centre@lse.ac.uk

AFTER INTERVIEW

An Adviser will do the initial review of the application, and, after being satisfied
that all relevant documentation is in place, will pass the application to the ACC
Panel for consideration.

DECISIONS OF THE PANEL

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The Panel meets twice a week to consider applications.

Within 3 working days of the applications being submitted to the Panel, you
will be notified of a decision.

If granted, the awarded sum is paid directly to the applicant in the form of a
cheque. The cheque would normally take an additional five working days to
produce.

RECONSIDERATION OF DECISIONS

If you are not happy with the decision of the Panel, then you may make a written
request to the Manager to the Advice and Counselling Centre for the matter to
be reconsidered.

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Personal Details

1. Surname: _______________________________________________

2. First name: ______________________________________________

3. (a) LSE Registration number: _______________________________

(b) Nationality ___________________________________________

4. Address: _______________________________________________

______________________________________________________

5. Telephone number: _______________________________________

6. E-mail: _________________________________________________

7. Age: ______________ 8. Male/Female

9. Do you have a husband/wife/partner? YES/NO

10. If yes, is he/she with you in London? YES/NO

11. Do you have any dependent children with you in London? YES/NO

12. If yes, how many? ___________

Course Details

13. Course Title: _____________________________________________

14. Undergraduate/Postgraduate

15. Full-time/Part-time

16. How long does the course last? ______________________________

17. What year of the course are you in? ___________________________

18. When did you start this academic year? ________________________

19. When will your academic year end?___________________________

20. Have you applied to this fund before in this academic year? Yes/No

If yes, please give date of application and state how much were you
awarded - ______________________

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21. When did you become aware of your disability?

22. What steps did you take on becoming aware of your disability to prepare
for covering any extra costs associated with your disability? Please
include information on any other applications for financial support from
other sources and any special or unexpected circumstances which
have affected your finances.

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23. Please give details of any expenditure relating to your disability. As this
application takes into account costs for the whole academic year, you should
include estimated future costs e.g. extra readers or photocopying during exam
time. The following categories are to assist you in your estimates; you do not
have to put a figure for each one but we need to be able to assess your extra
expenditure for the full academic year.

Weekly extra costs (How much and what for)

Termly costs (How much and what for)

Once a year costs (how much and what for)

Academic year total

24. Please give a breakdown of the expenditure you are seeking funding for?

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25. Please use this space to give any further information that may be relevant
to your application.