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OFFICE OF THE MAYOR Taguig City, Philippines
LIFELINE LIFELIN E ASSISTANCE ASSISTANCE FOR NEIGHBORS IN!NEE" IN!NE E" SCHOLARSHIP APPLICATION FORM
Recen 2@2 0 Picure (a1en in he las = monhs)
Basi#$S%C!LC%$Basi# & S%C$LC% Inst'u#ti(n) 1. PRINT all all entries. Place an X in the appropr appropriate iate blanks. blanks. 2. Be HONEST HONEST and A!RA A!RATE TE "ith #o$r ans"ers. ans"ers.
"ate%&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
SCHOLARSHIP APPLIE" FOR &&&& Basi# S#h(la'ship
**** Basi# Plus
**** S%C$LC%
**** Ne+ Appli#ant Appli#ant ***** Rene+ing S#h(la'ship N(- (. Se/este's that y(u ha0e 1ene2ite3 .'(/ .'(/ the S#h(la'ship ************* Basic Plus SUC/LCU Basic
1. 2.
3.
*.
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 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 Taguig or nearby LGUs in the NCR who are enrolled in any private college or university university,, or in any accredited technicalvocational technicalvocational institution institution in the NCR. NCR.
Please provide 2 (two) sets of all the documents. All photocopied photocopied documents should be faithful faithful reproduction reproduction of the original. Bring the original copies of documents for validation purposes. purposes. Ask for the “Receiving “Receiving Copy” Copy” upon submission. Fill up ALL the data reuirements in the Application Form and submit and submit ALL the documents reuired during the Application. Application. !ncompletely !ncompletely "illed#up $cholarship Application Forms or those %ith incomplete reuirements shall &'( be accepted) or !F inadvertently accepted) it shall &'( be processed. $ubmit your $cholarship $cholarship Application at the l.A.&.!. l.A.&.!. $cholarship $ecretariat $ecretariat 'f"ice at the Sen. the Sen. enato !"ompa#ero$ "a%etano &emorial Science and 'echnolog% igh School ("a%etano Science) Pamayanang Science) Pamayanang *iego $ilang) +rgy. ,susan) (aguig City) during during the application application period period '&L'&L-. Check Check the $cholarshi $cholarship p (aguig (aguig// F+ Account Account and %%% %%%.. taguig.g taguig.gov ov.ph .ph regularly regularly for announcement regarding dates and venue. Please do &'( %ait for the last day of the application period if you do not %ant to be inconvenienced) inconvenienced) or %orse re0ected.
CHECKLIST OF REQUIREMENTS TO BE SUBMITTED
_____ Filled-up Applicaton Form wih 2X2 Recen Recen Picure _____ Enrolmen Enrolmen Form for Curren Curren Semeser/erm Semeser/erm wih !"cial Receip# if applica$le _____ Auhentcaed Auhentcaed or rue rue Cop% of &rades las las semeser# semeser# wih school seal/o"cial si'naure (for rimeser# rimeser# 'rades for he pas 2 erms) _____ *i'h School Repor Card/!her Card/!her +alid proof of ha+in' ha+in' 'raduaed from *i'h School (for Freshmen/,ew Applicans) _____ Certcae Certcae of &ood .oral Characer Characer (ssued wihin he school %ear) _____ School 0 ($ac1 o o $ac1 phoocop% in a sin'le sin'le pa'e)
_____ !her necessar% documens documens o faciliae faciliae he processin' of %our scholarship applicaton (ranscrip or rue Cop% of &rades since sar of colle'e for ,ew Applicans who are contnuin' sudens# Scholarship oucher# ES Certcaton# F345# Course Curriculum# 6irh Certcae# ec7) _____ oer8s oer8s Certcaton issued $% C!.E9EC# C!.E9EC# showin' ha a leas one of he parens of he applican is a re'isered +oer (ssued a:er he .a% ;#2<3= electon) _____ oer>s oer>s Certcaton of he applican (for hose 3? %ears old and a$o+e)
PERSONAL INFORMATION
'$ll Na(e% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& )*ast Na(e+ )'irst Na(e+ ),iddle Na(e+ Address% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& Baran-a#% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& istrict )1 or 2+% &&&&&& /ears o0 Residenc# in Ta-$i- )applicant+% )applicant+% &&&&&&&&&& A-e% &&&&&&&&&&& ender% &&&&&&&&&&&&&&&&&&&& E(ail Address% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& ontact No.% &&&&&&&&&&&&&&&&&&&&& Reli-ion% &&&&&&&&&&&&&&&&&&&&&&&&&&& ate o0 Birth%&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& Place o0 Birth% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& ,arital Stat$s% &&&&&&&&&&&&&&&&&&&&& Residence% &&&&&&&O"ned b# 0a(il#&&&&&& O"ned b# relati3es &&&&&& Rentin- &&&&&Pa#in-too"n &&&&&Others )pls speci0#+% &&&&&&&&&&&&&&&&&&&&&&&&&& I0 rentin- or pa#in-too"n4 pa#in-too"n4 ho" ($ch are #o$ pa#in- (onthl#5% P&&&&&&&&&&&&&&&&&&&&&&&&& Ha3e #o$ #o$ been the ob6ect o0 an# disciplinar# action in school5 &&&&/es &&&&& No . Ha3e #o$ #o$ been acc$sed or con3icted o0 an# o00ense7cri(e5 o00ense7cri(e 5 &&&& /es /es &&&&& No I0 the ans"er ans"er to an# o0 the last 2 8$estions abo3e is 9/es4: 9/es4: please pro3ide details% CO%RSE an3 SCHOOL
o$rse% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&/ear &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&/ear *e3el% *e3el% &&&&&&&&&& ; A3e. A3e. last se(%&&&&&&&&&&&&&&&&& se(%&&&&&&&&&&&&&&&&& School%&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& School Address% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
G'a3uating this se/este'$te'/ **** Yes ***** N( I. yes, a'e y(u g'a3uating +ith h(n('s4 ******Yes ******* N( I. n(, h(+ /any se/este's /('e t( g( 1e.('e y(u g'a3uate, in#lu3ing the #u''ent se/$te'/4 ***************** E"%CATIONAL BAC5GRO%N"
Na/e (. S#h((ls Atten3e3
S#h((l Type )Indicate i0 P$blic or Pri3ate+
S#h((l A33'ess
Yea' Sta'te3 6 Yea' G'a3uate3
H(n('s$A+a'3s Re#ei0e3 )i0 an#+
Hi-h School Ele(entar#
FAMILY BAC5GRO%N" FATHER MOTHER 7 Li0ing 7 "e#ease3 7 Li0ing 7 "e#ease3
N$(ber o0 siblin-s in the 0a(il# )incl$din- applicant+%&&&&&&&. Please
! hereby certify that ALL the ans%ers given above are '+, and "-,"' to the best of my kno%ledge) and the attached documents are A/'+L ,0-+"'/- of the original copies. ! further ackno%ledge that A A"' - /S-,S' - ALS//"A'/- &A B, A 4-+ - & /S5+AL//"A'/- from this scholarship program. ! also understand that this submission of application does -' automatically ualify me for the scholarship grant and that ! %ill abide by the decision of the L.A.&.!. $cholarship 1anagement. (hank you so much.
