TSLB 04 01 Extension of Award PDF

Tertiary Scholarship and Loans Board
“Building a Smarter Fiji”

TSLB 04-01
APPLICATION FOR EXTENSION OF AWARD
A. Instructions
1. All the required information must be completely filled by the applicant.
2. All required documents/evidences must be attached.
3. Incomplete and late applications will not be considered by TSLB. Visit www.tslb.com.fj or our Facebook
Account (Tertiary Scholarship and Loans Board) for information on due dates for each academic term and
year.
4. Duly completed form must be hand-delivered to a TSLB office nearest to you. Forms submitted through
emails will not be considered.
5. Requests for extension will only be considered by TSLB if the applicant has shown satisfactory academic
progress till the time of the application for the extension, meaning the current accumulative GPA has to be
2.0 or above.
6. Request for extension will only be approved if the student will be able to complete the studies in no more
than 2 academic terms from the time of the application for the extension (equating to 8 or less units).
B. PERSONAL DETAILS
TIN Number: Student ID No:
Surname: First Name:
Other Name(s): Email Address:
Phone Contact: Institution Name:
Campus Name: Current Program of
Study:
Current Major(s)/Minor: TSLB Scheme Name:
Year of Commencement under Term of Commencement
TSLB Scheme: under TSLB Scheme:
Prior approved changes in Year in which change was
program by TSLB approved before
C. PARTICULARS RELEVANT FOR THE APPLICATION
No: Of Courses/Units in the Program: No: Of Courses Completed:
No: Of Courses Remaining: Period till which extension is requested:
D. MANDATORY DOCUMENTS TO ATTACH (Please tick the documents attached with this application)
1 Full Academic 2. Program Audit Certificate
Transcript
Program Outline for the remaining courses/units (Year and Term in which these will be
3
offered, and how you plan to complete).
4 Letter explaining the reason(s) for not completing the program within the sponsored
duration, along with any evidences such as medical certificates/letter from university.
E. APPLICANTS DECLARATION
The information provided in my application is, to the best of my knowledge, complete and accurate, and I understand
that false statements on this application will disqualify me from the scheme and can result in the termination of the
award. TSLB reserves the right to seek any additional information from me before making the final decision. I have
also read and fully understood the terms and conditions of this application as stated in Part A of this form and also the
policies available on the TSLB website www.tslb.com.fj.
Applicants Name: Applicants Signature: Date
F. For Official Use Only
Page 1 of 2
The application has been: Approved Rejected
(all approvals are subject to the terms and conditions below and the student returning a signed and JP/Commissioner
of Oaths witnessed terms and conditions back to TSLB).
Reason for Rejection ……………………………………………………………………………………………………………………….........................................
…………………………………………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………
Condition(s) for Approved Extension (Cross off whichever is not applicable)
1. Extension is Granted for one academic term only (Immediate term after the approval date). The approved term
being ……………………………………………………….
2. Any further extension (upon application- for a maximum of one more academic term) will be subject to you
satisfying the following conditions below:
i Had enrolled on a full academic load during the term for which extension had already been granted;
ii Have achieved a 100% pass rate; and
iii The term for which the second and final extension is sought is your graduating term meaning you will complete
your studies in this second term of extension.
3. There will be no automatic extension by TSLB at the end any approved period of extension. You must re-apply for
extension at the end of the initial period of extension subject to conditions (2) above.
4. During the period of extension, you will be placed on a probationary period. Should you fail any courses/units
during the period of extension, your award will be terminated and recovery action will commence.
5. Extension is for Tuition only. No allowances or hostel fees will be paid by TSLB during the extension period.
6. Extension is on Tuition and allowances both. However, no new allowances are approved or will be approved during
any period of extension.
7. No Tuition or allowances will be paid until TSLB receives the signed copies of this letter.
8. Should you accept the above terms and conditions at free will, kindly complete the section below, print and sign 2
copies and return an original signed copy to TSLB within 5 days from the date of this approval while the second
original copy should be retained by you.
9. Any Special Condition(s) (TSLB Staff to Specify) ………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………..
.………………………………………………………………………………………………………………………………………………………………………….
TSLB Decision Officer Name: …………………………………………. Signature: …………………………………. Date: ………………
To be filled by the Student

(This part needs to be filled by the students AFTER TSLB has approved the request for extension)
I, ...................................................................... THE UNDERSIGNED, HEREBY ACCEPT THE TERMS AND CONDITIONS
PRESCRIBED ABOVE AFTER THE CONTENTS HEREOF WERE FIRST EXPLAINED TO ME IN THE ENGLISH LANGUAGE AND I
APPEARED TO FULLY UNDERSTAND THE MEANING AND EFFECT OF THE SAME. I ALSO FULLY UNDERSTAND AND AGREE
TO THE CONDITION THAT SHOULD I FAIL TO MEET THE ACADEMIC REQUIREMENTS AS PRESCRIBED IN THIS LETTER,
BOND FORM AND THE OFFER LETTER THAT I HAVE SIGNED WITH TSLB/FRCS, MY SPONSORSHIP WILL BE TERMINATED
WITHOUT ANY NOTICE AND RECOVERY ACTIONS WILL COMMENCE.
Signature of Student: ........................................... Date: ..................................................................
Student ID No: ..................................................... Tax Identification Number: ................................
[To be witnessed by a Justice of Peace or Commissioner of Oaths]
Full Name of Witness and Stamp: …………………………………………………. Signature of Witness: …………………………………
Full Address of Witness: …………………………………………………...................................... Date: ……………………………
For Official Use only
Date Entry Officer’s Name: ………………………………………...…… Signature: …………………………… Date: ………………………….
Data Entry Verifications Officers Name: ………...……………………. Signature: ………………………… Date: …………………………..
© Tertiary Scholarship and Loans Board 2020 Version 1 of 2020
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Tertiary Scholarship and Loans Board

“Building a Smarter Fiji”

No: Of Courses/Units in the Program: No: Of Courses Completed:

No: Of Courses Remaining: Period till which extension is requested:

To be filled by the Student

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