NATIONAL

YOUTH
PARLIAMENT
APPLICATION FORM
November 5-8, 2010 This form may be reproduced

Region: ____________________
Print legibly. Shade appropriate “ “.
1. PERSONAL INFORMATION

Name S 2x2
Last Name First Name Middle Name
Date of Birth Age Sex Religion
mm/dd/yy
Official Mailing Address

E-mail Address
CATEGORY OF DELEGATES
Contact Number In school Youth
Landline Mobile phone Out-of school Youth
Allergies Working Youth
2. EDUCATIONAL BACKGROUND Specific Youth
Groups/Youth with
Special Needs
Sangguniang
Name of Schools / Highest Level Kabataan
Inclusive Dates
College / University Attained
High School
College
Vocational
Post Graduate

3. ORGANIZATIONAL MEMBERSHIP (* Please attach additional sheet if necessary)

Organization Inclusive Dates Position Held

4. INVOLVEMENT IN YOUTH/COMMUNITY RELATED ACTIVITIES (* Please attach additional sheet if

necessary)

Inclusive Dates Description

5. HOW DID YOU KNOW ABOUT NYP? Newspaper Magazine Internet Others:______

6. DO YOU HAVE KNOWLEDGE IN PARLIAMENTARY PROCEDURES? Yes No

7. HAVE YOU BEEN INVOLVED IN ANY NYC PROGRAMS OR ACTIVITIES? Yes No

Name of NYC Program Involvement Inclusive Dates

8. HAVE YOU EVER BEEN CONVICTED OF ANY CRIME INVOLVING Yes No

MORAL TURPITUDE?
9. DO YOU HAVE ANY PENDING CASE (S) IN COURT? Yes No

10. COMMITTEE MEMBERSHIP (Pls. rank according to top 4 priority, where 1 is the highest priority)
Sustainable Development Employment/Entrepreneurship
Education Participation

Health Values
Other relevant and emerging youth issues:
Special Needs

PARENTAL CONSENT (for below 18 years old)

I, ___________________, mother, father, legal guardian of Ms./Mr._________________________ do hereby

understand and that I have read the information provided above and decided to allow my child to participate.

____________________________
Signature over printed name

CERTIFICATION

I hereby certify that all facts and information indicated herein are true and correct to the best of my
knowledge. I further declare that any information given by me, which is untrue, may constitute a ground for
expulsion in the National Youth Parliament and prosecution of perjury.

Further, I subscribe and agree that the National Youth Commission has the sole prerogative to select
and nominate the delegate to the NYP, and its decision is final and executory.

I am willing to shoulder my transportation/travelling expenses necessary to facilitate my participation

to the activity.

__________________________________ ___________________________________
Date accomplished Signature of applicant

QUALIFICATIONS OF APPLICANT APPLICATION REQUIREMENTS

 Filipino citizen, between 15 to 30 years old as Applicant must secure copies of the following:
of June 30, 2010  8 copies of application letter
 Able to read and write  8 copies of accomplished NYP application
 Residing in at the place for not less than six form with 2x2 pictures attached to each form
(6) months at the time of submission  1 Self-addressed mailing envelope, with
 Must be an officer of a youth organization or twenty (20) pesos (Php 20.00) worth of
youth-serving institution stamps
 Of good moral character  1 original and 7 photocopies of Birth
 Has not been convicted of any crime involving Certificate
moral turpitude  1 original and 7 photocopies of Barangay
Clearance
 1 original and 7 photocopies of Certification
from youth organization/institution
represented
 8 copies of Proposed resolution
Mail or hand-carry your application to Mr. Rudyboy R.
DEADLINE IS JUNE 30, 2010 Sinay, National Youth Commission, 4/F Bookman Bldg.,
373 Quezon Avenue, Quezon City
Contact Number: 781-1406
 8th NYP Resolutions Template

8th National Youth Parliament

Name
Region
Youth Issue
Resolution