Revised OSDS FORM NO.

3
2014version(NOT FOR SALE)

Office of the President of the Philippines

COMMISSION ON HIGHER EDUCATION
REGIONAL OFFICE III 2X2
ID PICTURE

CHED STUDENT FINANCIAL ASSISTANCE PROGRAMS (StuFAPs)

APPLICATION FORM

Instructions: Read General and Documentary Requirements. Fill in all the required information. Do not leave an item blank. If item is not applicable, indicate "N/A".

PERSONAL INFORMATION
Name

(Last Name) (First Name) (Middle Name)

Permanent Mailing
Date of Birth (mm/dd/yy)
Address
Place of Birth
Sex  Male  Female Zip Code
Civil Status
 Single  Widowed School Name (SHS)
School Address
 Married  Separated

 Annulled  Others

Citizenship School Type ( )Public ( )Private

Mobile Number Highest Grade/Year

E-mail Address Type of Disabilty (if applicable):___________ Tribal Membership (if applicable):___________
FAMILY BACKGROUND
Father: ( ) Living ( ) Deceased Mother: ( ) Living ( ) Deceased

Name

Address

Occupation

Educational Attainment
Total Parents Gross Income: No. of Siblings in the family(Including the applicant):_____
School currently ENROLLED or intended to enroll:
School Address:
Type of School: ( ) Public ( ) Private
Degree Program: ( ) Priority ( ) Non-Priority (list at the back)

(Signature over Printed Name of Applicant) Date Accomplished

DO NOT FILL-OUT THIS PORTION (FOR CHED USE ONLY)

Applicant is Qualified for: Belongs to: (any of the following groups) Documents Attached: Equivalent Points

Scholarship solo parent and their dependents Form 138 =

Grants-In-Aid senior citizens Latest ITR P =
persons with disabilities Total =

indigenous and ethnic peoples

Evaluated/Processed by:

CHED StuFAP Coordinator

Documentary requirements: Documentary requirements:
A. Incoming First Year: A. For Applicants with earned units in College:
1. For Senior high school applicants - Grade 11 report card and Grade 12 second semester grades. 1. Certification of grades in all subjects in the last two (2) semesters for Academic Year 2018-
2019
2. Certificate of good moral character from the last school attended. 2. Certificate of good moral character from the last school attended.

OTHER REQUIREMENTS (FOR PARENTS OR GUARDIAN):
B. Any of the following: Latest Income Tax Return (ITR) of parents or guardian, Certificate of Tax
Exemption from the Bureau of Internal Revenue (BIR), Certificate of Indigency from the
Barangay, Case Study from DSWD, For children of OFW and Seafarers latest copy of contract
or proof of income or Affidavit of No Income.
OTHER REQUIREMENTS (FOR PARENTS OR GUARDIAN):
B. Any of the following: Latest Income Tax Return (ITR) of parents or guardian, Certificate of Tax
Exemption from the Bureau of Internal Revenue (BIR), Certificate of Indigency from the
Barangay, Case Study from DSWD, For children of OFW and Seafarers latest copy of contract
or proof of income or Affidavit of No Income.

General Requirements: A. For other applicants:

1. Must be a Filipino citizen. 1 ALS - Alternative and Equivalency Test Passers Certificate.
2. Must be a senior high school graduate or a candidate for graduation; with earned units in Collage; 2 PEPT - Certificate of Advancing to the Next Level.
passer of ALS/PEPT;

3. Must avail only one CHED scholarship or financial assistance program;

4. Must not be a graduate of any degree program; and must have a combine annual gross income
of parents/guardian not exceed Three hundred thousand pesos (PhP300,000.00).
OTHER REQUIREMENTS (FOR PARENTS OR GUARDIAN):
B. Any of the following: Latest Income Tax Return (ITR) of parents or guardian, Certificate of Tax
Exemption from the Bureau of Internal Revenue (BIR), Certificate of Indigency from the
Barangay, Case Study from DSWD, For children of OFW and Seafarers latest copy of contract
or proof of income or Affidavit of No Income.

Deadline for filing - April 30 of every year