LIFELINE ASSISTANCE FOR NEIGHBORS
IN-NEED Incompletely filled-up Scholarship
SCHOLARSHIP CHECKLIST
Basic/SUC/LCU/Basic + SUC/LCU
Name:
____________________________________________
_______________
School:
____________________________________________
_______________
CHECKLIST OF REQUIREMENTS TO BE
SUBMITTED (2 sets)
_____ Filled-up Application Form with 2X2
Recent Picture
_____ Enrolment Form for the 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 Card/Any proof of having
graduated from your stated High School
(for Freshmen/New Applicants)
_____ Certificate of Good Moral Character
(Issued within the year)
_____ School ID (back to back photocopy in a
single page)
_____ Other necessary documents to
facilitate the 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 issued after May 2013
showing that at least one of the parents
of the applicant is a registered voter
_____ Voters Certification of the applicant
(for 18 years old and above)
Instructions
1. Please submit your Scholarship
Application at the Senator Renato
"Compaero" Cayetano Memorial
Science and Technology High
School (SRCC or Cayetano Science),
Pamayanang Diego Silang, Brgy. Ususan,
Taguig City on the dates of acceptance
of application. Check the Scholarship
Secretariat (Taguig) FB Account and
www.taguig.gov.ph regularly for
announcements regarding dates and
venue.
2. Please come with 2 (two) sets of all
the documents. All photocopied
documents to be submitted should be
faithful reproduction of the original.
Bring the original copies of
documents for validation purposes.
Ask for the Receiving Copy upon
submission.
3. Please fill up all the data
requirements in the Application
Form and submit all the
documentary requirements needed
during the Application Period.
Application Forms or those with
incomplete requirements shall NOT be
accepted, or IF inadvertently accepted,
it shall NOT be processed.
LIFELINE ASSISTANCE FOR NEIGHBORS
IN-NEED
SCHOLARSHIP CHECKLIST
Basic/SUC/LCU/Basic + SUC/LCU
Name:
____________________________________________
_______________
School:
____________________________________________
_______________
CHECKLIST OF REQUIREMENTS TO BE
SUBMITTED (2 sets)
_____ Filled-up Application Form with 2X2
Recent Picture
_____ Enrolment Form for the 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 Card/Any proof of having
graduated from your stated High School
(for Freshmen/New Applicants)
_____ Certificate of Good Moral Character
(Issued within the year)
_____ School ID (back to back photocopy in a
single page)
_____ Other necessary documents to
facilitate the 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 issued after May 2013
showing that at least one of the parents
of the applicant is a registered voter
_____ Voters Certification of the applicant
(for 18 years old and above)
Instructions
1. Please submit your Scholarship
Application at the Senator Renato
"Compaero" Cayetano Memorial
Science and Technology High
School (SRCC or Cayetano Science),
Pamayanang Diego Silang, Brgy. Ususan,
Taguig City on the dates of acceptance
of application. Check the Scholarship
Secretariat (Taguig) FB Account and
www.taguig.gov.ph regularly for
announcements regarding dates and
venue.
2. Please come with 2 (two) sets of all
the documents. All photocopied
documents to be submitted should be
faithful reproduction of the original.
Bring the original copies of
documents for validation purposes.
 Ask for the Receiving Copy upon
submission.
3. Please fill up all the data
requirements in the Application
Form and submit all the
documentary requirements needed
during the Application Period.
Incompletely filled-up Scholarship
Application Forms or those with
incomplete requirements shall NOT be
accepted, or IF inadvertently accepted,
it shall NOT be processed.
 OFFICE OF THE MAYOR
Taguig City, Philippines

LIFELINE ASSISTANCE FOR NEIGHBORS IN-NEED

SCHOLARSHIP APPLICATION FORM
Basic/SUC/LCU/Basic + SUC/LCU

Instructions:
1. PRINT all entries.
2. Place an X in the appropriate blank provided.
Date:__________________________________

SCHOLARSHIP APPLIED FOR

_____ Basic Scholarship _____ SUC/LCU _____ Basic + SUC/LCU

_____ New Applicant _____ Renewing Applicant
School Year: _________________ Semester: _____ 1st Sem _____ 2nd Sem

Number of semesters that you have benefitted from the Scholarship:

_______________________

PERSONAL INFORMATION

Name:
_________________________________________________________________________________________
_______________________
(Last Name) (First Name) (Middle
Name)
Address:
_________________________________________________________________________________________
____________________
Barangay: _________________________________________ Years of Residency in Taguig
(applicant): _________
Mobile/Landline Phone Numbers:_________________________________________________
Age: _________________
Place of Birth: ____________________________________ Date of
Birth:___________________________________________
Gender: ____________ Marital Status: ____________ Religion:
________________________________________________
E-mail Address:
______________________________________________________________________________
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:
_________________________________________________________________________________________
_______________________________

EDUCATIONAL BACKGROUND

Course:
_________________________________________________________________________________________
______________________
Year Level: _______ Graduating this semester? _____Yes _____No Grade Ave. last
sem:_______________
Regular duration of Course: _____5 years _____4 years _____3 years _____2 years
_____Others (specify)
____________________________________________________________
How many semesters more to go before you graduate, including the current sem/term?
_________________

School:__________________________________________________________________________________
______________________________
School Address:
_________________________________________________________________________________________
____________

School Year
Type Started Honors/Award
Name of Schools (Indicat School Address Year s Received
Graduated From e if (Barangay and Graduat (if any)
Public City/Municipality) ed
or
Private)
High School:

Elementary:
 FAMILY BACKGROUND

FATHER MOTHER HUSBAND/WIFE

( ) Living ( ) ( ) Living ( ) (If Married)
Deceased Deceased
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:
Age Marit Highest If working, indicate
al Educational where they work &
Name Statu Attainment their average monthly
s (M (as of date) income
or S)

I hereby certify that ALL the answers given above are TRUE and CORRECT to
the best of my knowledge and that the attached documents are faithful reproduction of
the original copies. I further acknowledge that ANY ACT OF DISHONESTY OR
FALSIFICATION MAY SERVE AS A GROUND FOR MY PERPETUAL
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 very much.

_____________________________________________________________________________
_______________________________
Printed Name & Signature of Applicant
Date

Attested by:

_____________________________________________________________________________
______________________________
Printed Name & Signature of Parent/Legal Guardian
Date
Rev.3.8.15

Investing in education, investing in the Citys Foundation!