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De La Salle University

D A S M A R I Ñ A S
C A VI TE 4115 P H I L I PPI N ES

DLSU-D
Scholarship
NIGHT COLLEGE
Application
STATEMENT OF PURPOSE
In accordance with the mission-vision of De La Salle University-Dasmariñas
– touching hearts, teaching minds, and transforming lives, the College of
Business Administration and Accountancy DLSUD Night College continue to
serve the needs of the indigent working youth of Cavite. It is the desire of
the program to provide free quality education to underprivileged working
youth despite its limited resources.

CRITERIA
Individuals selected for the scholarship must be:

1. A resident of the Province of Cavite;


2. 18 years old and above;
3. A high school/senior high school graduate with a Grade Point Average
of not less than 85%;
4. A permanent or probationary employee at the time of enrollment;
5. Minimum wage earner or low-income individual;
6. An individual with a good sense of time management and drive to
succeed and;
7. Able to pass the De La Salle University – Dasmariñas entrance
examination.

REQUIREMENTS
Applicants for scholarship should be able to provide the following
documents:

1. Form 138 (high school report card) or ALS Certificate


2. Certificate of Good Moral Character
3. Birth Certificate (with NSO Authentication)
4. Certificate of Employment
5. Certificate of Non-Filing of Income Tax
6. Health Certificate
7. Certificate of Indigence
8. Letter of Endorsement from School(Teacher, Principal) or Parish
(Priest, Deacon, Pastor) or Public Servant (Barrio Captain, Mayor) or
Head of civic organization (President, Chairman)
9. Picture of house.
SCHOLARSHIP APPLICATION Paste a 2x2 or Passport size

ID Picture
PLEASE PRINT IN INK OR TYPE ALL INFORMATION.

A. PERSONAL INFORMATION
Surname Given Name Middle Name

Mailing Address:
___Owned
___Rented
Residential Address(if different from above):
___Owned
___Rented
Home Phone: Work Phone: Cellular Phone:

Current Age: Date of Birth: Place of Birth:

Marital Status:
___Single ___Married ___Widowed ___Legally Separated ___Annulled
Spouse Name:

Occupation: No. of Children:

Father’s Name:

Occupation: Educational Attainment:

Mother’s Name:

Occupation: Educational Attainment:

Brothers and Sisters Educational Attainment Occupation

B. EDUCATIONAL INFORMATION
(School, Address, Years Attended) (Awards/Recognition/GPA)

Primary

Junior High School

Senior High School/Track

Vocational/Tesda

Associate Degree

College

1. Are you currently attending college? YES_____ NO____


If YES: School:______________, Course:_________, Year Level:___, Units
completed:____
2. What course of study (major) do you plan to pursue?_______________________
3. Field of interest (math, science, business, etc) :____________________________________
C. EMPLOYMENT INFORMATION
Please list your employers for the past five years beginning with your present or most
recent employer:
COMPANY ADDRESS JOB TITLE INCLUSIVE DATES SALARY

D. REFERENCES
1. Please list three people (not related to you) who are familiar with your life experiences
and with your character.
Name: Affiliation: Contact Number:

Name: Affiliation: Contact Number:

Name: Affiliation: Contact Number:

2. Nepotism Statement. Please list relatives and/or friends studying or employed in De La


Salle University-Dasmariñas.
Name: Relationship:

Name: Relationship:

Name: Relationship:

E. Essay
“Why I strongly believe I deserve to be a scholar of the
DLSU-D Night College”

I certify that the statements herein are true to the best of my knowledge and grant
my permission for the information contained herein to be shared with the DLSU-D
Night College scholarship selection committee.

____________________________
Signature over printed name
Date:_________________