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OFFICE OF THE MAYOR

Taguig City, Philippines


LIFELINE ASSISTANCE FOR NEIGHBORS IN-NEED
SCHOLARSHIP APPLICATION FORM

Recent
2x2
ID Picture
(taken in the last
6 months)

Basic/SUC-LCU/Basic + SUC/LCU

Instruction:
1. PRINT all entries. Place an X in the appropriate blanks.
2. Be HONEST and ACCURATE with your answers.
Date:_____________________________
____ Basic Scholarship

SCHOLARSHIP APPLIED FOR


____ Basic Plus

____ New Applicant _____ Renewing Scholarship


Scholarship _____________

Basic Plus
SUC/LCU
Basic

____ SUC/LCU

(No. of Semesters that you have benefited from the

Graduates of public high schools in Taguig or nearby LGUs in the NCR, who are enrolled or
enrolling in an SUC or LCU in the NCR.
Graduate of private school in Taguig or nearby LGUs in the NCR, who are enrolled or enrolling in
an SUC or LCUs in the NCR.
Graduate of any public high school in Taguig or nearby LGUs in the NCR who are enrolled in any
private college or university, or in any accredited technical-vocational institution in the NCR.

1. Please provide 2 (two) sets of all the documents. All photocopied documents should be faithful
reproduction of the original. Bring the original copies of documents for validation purposes. Ask
for the Receiving Copy upon submission.
2. Fill up ALL the data requirements in the Application Form and submit ALL the documents required
during the Application. Incompletely filled-up Scholarship Application Forms or those with incomplete
requirements shall NOT be accepted, or IF inadvertently accepted, it shall NOT be processed.
3. Submit your Scholarship Application at the l.A.N.I. Scholarship Secretariat Office at the Sen. Renato
Compaero Cayetano Memorial Science and Technology High School (Cayetano Science),
Pamayanang Diego Silang, Brgy. Ususan, Taguig City, during the application period ONLY. Check the
Scholarship (Taguig) FB Account and www. taguig.gov.ph regularly for announcement regarding dates
and venue.

CHECKLIST
OF
REQUIREMENTS
TO
BE
SUBMITTED
_____ Filled-up Application Form with 2X2 Recent
Picture
_____ Enrolment Form for Current Semester/Term with
Official Receipt, if applicable
_____ Authenticated or True Copy of Grades last
semester,
with school seal/official signature (for
trimester, grades
for the past 2 terms)
_____ High School Report Card/Other valid proof of
having
graduated from High School
(for Freshmen/New Applicants)
_____ Certificate of Good Moral Character
(Issued within the school year)
_____ School ID (back to back photocopy in a single
page)

_____ Other
facilitate the

necessary

documents

to

processing of your scholarship


application
(Transcript or True Copy of Grades
since
start of college for New Applicants
who are
continuing students, Scholarship
Voucher,
EVS Certification, F137, Course
Curriculum,
Birth Certificate, etc.)
_____
Voters
Certification
issued
by
COMELEC, showing that at least one of the
parents of the applicant is a registered voter
(Issued after May 2013)
_____ Voter's Certification of the applicant
(for those 18 years old and above)

PERSONAL INFORMATION
Full
Name:
________________________________________________________________________________________________________
____________
(Last Name)
(First Name)
(Middle Name)
Address:
___________________________________________________________________
Barangay:
_______________________________________
District (1 or 2): ______
Years of Residency in Taguig (applicant): __________
Age: ___________
Gender: ____________________
E-mail Address: ___________________________________ Telephone No.: _____________________ Religion:
___________________________
Date of Birth:______________________________ Place of Birth: _______________________________ Marital
Status: _____________________
Residence: _______Owned by family______ Owned by relatives ______ Renting _____Paying-to-own
_____Others (pls specify): __________________________ If renting or paying-to-own, how much are you
paying monthly?: P_________________________

Have you been the object of any disciplinary action in school? ____Yes _____ No . Have you been
accused or convicted of any offense/crime? ____ Yes _____ No If the answer to any of the last 2
questions above is Yes, please provide details:
COURSE and SCHOOL
Course: ___________________________________________________________Year Level: __________ GW Ave. last
sem:_________________
School:_________________________________________________________________________________________________
__________________________
School
Address:
________________________________________________________________________________________________________
________

Graduating this semester/term ____ Yes _____ No


If yes, are you graduating with honors?
______Yes _______ No
If no, how many semesters more to go before you graduate, including the current
sem/term? _________________

Name of Schools
Attended

EDUCATIONAL BACKGROUND
School
Year
Type
Started
(Indicate
School Address
Year
if Public
Graduat
or
ed
Private)

Honors/Award
s Received
(if any)

High School
Elementary

FAMILY BACKGROUND
FATHER
MOTHER
( ) Living ( )
( ) Living ( )
Deceased
Deceased

HUSBAND/WIFE
(If Married)

Name
Address
Contact No.
Occupation
Place of Work
Highest Educational
Attainment
Ave. Monthly Income

Number of siblings in the family (including applicant):_______. Please fill out information below about
your siblings:
Ag Marita
Highest
If
working,
indicate
e
l
Educational
where they work & their
Name
Status
Attainment
average monthly income
(M
or
(as of date)
S)

I hereby certify that ALL the answers given above are TRUE and CORRECT to the best of my
knowledge, and the attached documents are FAITHFUL REPRODUCTION of the original copies. I
further acknowledge that ANY ACT OF DISHONESTY OR FALSIFICATION MAY BE A GROUND FOR
MY DISQUALIFICATION from this scholarship program.

I also understand that this submission of application does NOT automatically qualify me for the
scholarship grant and that I will abide by the decision of the L.A.N.I. Scholarship Management.
Thank you so much.
_____________________________________________________________
Printed Name & Signature of Applicant
Date: ____________________________________________________
Attested by:
__________________________________________________________________
__________________________________________
Printed Name & Signature of Parent/Legal Guardian

Investing in education, investing in the Citys Foundation!

Date: