General Claim Form for the payment Of Grant Aid

General Claim Form for the payment Of Grant Aid

The completed claim form should be submitted to:

Special Needs and Tuition Grants (SNTG), Schools Division Financial, Department of Education,

Cornamaddy, Athlone, Co. Westmeath, N37 X 659

SECTION 1: APPLICANT DETAILS

Name: ________________________________________ PPSN: ________________________________________

Address: __________________________________________________________________________________________

Email Address: __________________________________ Contact telephone number: _____________________

BANK ACCOUNT DETAILS

Name & Address of Bank: ____________________________________________________________________________

Name on Account: __________________________________________________________________________________

Bank (BIC) Code: ____________________________________________________________________________________

IBAN code: ________________________________________________________________________________________

DETAILS OF GRANT AID SOUGHT

__________________________________________________________________________________________

__________________________________________________________________________________________

Please attach a copy of the Approval/Sanction/Notification Letter/ Service Level Agreement issued by this Department

in respect of this grant aid.

Receipt Requirements: Where the grant aid sought is by way of a refund of fees already paid please attach the

receipt/payslip.