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Republic of the Philippines Office of the President COMMISSION ON HIGHER EDUCATION Regional Office 10
2X2 ID PICTURE
Tulong-Dunong (TD) (PWD, SP-IEP(Tribe) , CHED DND PASUC, OPPAPP-CHED Study Grant Program for Rebel Returnees, Solo Parent) (80-84% GWA) Others (pls. Specify) ___________________
PERSONAL INFORMATION
Name (Last Name) Age: Sex: Date of Birth: Complete Mailing Address: Status: (First Name) Religion: Place of Birth: (Middle Name) Citizenship: Tel./Mobile Number:
Home/Provincial Address: School Name (High School): School Address: School Type: ( ) Public ( ) Private ( ) Vocational Report Card Average: Highest Grade/Year: Date of Graduation: Rank in Graduating Class: National Career Assessment Examination (NCAE) GSA Percentile Rank: Date of Exam: Academic Awards/Honors Received: ________________________________________________________________________________ Number of children in the family:________________
FAMILY BACKGROUND
Father ( ) Living ( ) Deceased Mother: Name: Address: Occupation: Educational Attainment: Tribe Membership (for SP-IEP only): Authenticated certificate from OPAPP (OPAPP-CHED SGP-RR only) Total Parents Gross Income: Brothers/Sisters Enjoying Scholarship: Name: Scholarship ( ) Living ( )
School Intended to enroll in: Factor(s) that Motivated you to chose your course:
Programs and Schools
School
MARCH 31
Documentary Requirements
- Form 137 of 3rd year & Form 138 of 4th year (photocopy signed by the Principal at least 3rd grading ) - Latest BIR Income Tax Return (ITR) or Tax Exemption of parents; (max of 300, 000 for both parents) - Certificate of Good Moral Character from the High School Principal or Guidance Counselor - National Career Assessment Examination Rating.
Full Merit (90% Above) Half Merit (85-89%) Others ( 84-80%)
BS Chemistry
LIST OF HIGHER EDUCATION INSTITUTIONS 1 Cagayan de Oro College 2 Capitol University 3 La Salle University 4 Liceo de Cagayan University 5 Lourdes College 6 Pilgrim Christian College 7 Misamis University d. Engineering 8 Mountain View College Mechanical 9 Southern de Oro Philippines College Electronics 10 Saint Michael's College - Iligan City Communication 11 Xavier University Metallurgical/Mining 12 Bukidnon State University - Malaybalay City Computer 13 Camiguin Polytechnic State College Biomedical 14 Central Mindanao University - Bukidnon Chemical 15 Mindanao University of Science and Technology Geodetic 16 Mindanao State University - Iligan Institute of Technology Electrical 17 MOSCAT Meteorological 18 North Central Mindanao College Mining (For grantees in grant-in-aid programs, they may study in any CHED Geological recognized higher education institution preferably in state colleges and universities) e. Arts and Humanities; Atmospheric Sciences, and Environmental Sciences
Republic of the Philippines Office of the President MMISSION ON HIGHER EDUCATION Regional Office 10
ID PICTURE
_____________________________________________________________________
FAMILY BACKGROUND
Deceased
School
teness of information provided. Any misinformation will automatically disqualify I / We are also willing to refund all financial benefits received plus the appropriate / our child accepted the reward. I/we hereby authorize CHED-OSS/CHEDRO to conduct a background check on
umentary Requirements
r; (3) certificate of guarantor of loan by a bonifide member of GSIS or moral from school currently enrolled in, and (5) ITR or Tax Exempt. Cert.
CHED PRIORITY COURSES OM AY 2011-2012 TO AY 2015-2016 D MEMORANDUM ORDER No. 04, S. 2011)
Office of the President of the Philippines COMMISSION ON HIGHER EDUCATION Regional Office 10 Tel. No. 71-12-31
2X2 ID PICTURE
PERSONAL INFORMATION
Name Date of Birth (mm/dd/yy) Place of Birth Sex Civil Status
Male Single Married Annulled Female Widowed Separated Others (Last Name) (First Name) (Middle Name)
Permanent Mailing Address Zip Code School Name School Address School Type Public Highest Grade/Year Type of Disability (if applicable) Private
FAMILY BACKGROUND
Father ( ) Living Name: Address: Occupation: Educational Attainment: Total Parents Gross Income: Brothers/Sisters Enjoying Scholarship: Name: Scholarship ( ) Deceased Mother: ( ) Living ( ) Deceased
) Public
) Private
MARCH 31
Belongs to: (any of the following groups) solo parent and their dependents senior citizens persons with disabilities indigenous and ethnic peoples
Evaluated/Processed By:
CHED StuFAP Coordinator General Requirements: 1. Must be a Filipino citizen of good moral character 2. Must not be more than 30 years of age at the time of application except for senior citizens 3. Must be a high school graduate or a candidate for graduation 4. Must have a combined annual gross income of parents/guardian not to exceed Three Hundred Thousand Pesos (P300,000.00). For those who are exempted from filing income tax, there should be a certificate of tax exemption from the BIR. For OFW and Seafarers, a latest copy of contract or proof of income. 5. Must not be a recipient of any government and financial assistance Documentary Requirements: 1. Accomplished CHED StuFAPs Application (OSS Form 01) 2. Duly certified High School Report Card for third year and grades for the first three grading periods for fourth year 3. Latest Income Tax Return (ITR), Certificate of Tax Exemption or Copy of Contract or proof of income of parents/guardian from BIR. 4. Certificate of good moral character from the high school principal/guidance counselor.
b. Information Technology Information Technology and Computing Studies Multi Media Animation Information System Management Programming Computer Science c. Agriculture and Related Fields Agro Forestry Veterinary Medicine Agricultural Engineering Agribusiness/Management Agricultural Entrepreneurship Agri-Tech Agriculture Fisheries
LIST OF HIGHER EDUCATION INSTITUTIONS 1 Cagayan de Oro College 2 Capitol University 3 La Salle University 4 Liceo de Cagayan University 5 Lourdes College 6 Pilgrim Christian College 7 Misamis University d. Engineering 8 Mountain View College Mechanical 9 Southern de Oro Philippines College Electronics 10 Saint Michael's College - Iligan City Communication 11 Xavier University Metallurgical/Mining 12 Bukidnon State University - Malaybalay City Computer 13 Camiguin Polytechnic State College Biomedical 14 Central Mindanao University - Bukidnon Chemical 15 Mindanao University of Science and Technology Geodetic 16 Mindanao State University - Iligan Institute of Technology Electrical 17 MOSCAT Meteorological 18 North Central Mindanao College Mining (For grantees in grant-in-aid programs, they may study in any CHED Geological recognized higher education institution preferably in state colleges and universities) e. Arts and Humanities; Atmospheric Sciences, and Environmental Sciences
e of Technology