Certificate of Candidacy (1)

Republic of the Philippines Department of Education Region IV   Division of Oriental Mindoro

Formon National High School

SUPREME STUDENT GOVERNMENT Commission on Elections Formon

CERTIFICATE OF CANDIDACY INSTRUCTIONS: (Read well before filing up this form.) 1.) File this in ONE (1) LEGIBLE copy. 2.) File this certificate of candidacy with all the required information accurately and legally.

I hereby annou announce nce my candidacy for the position of ____________ ____, Supreme Student Government, in the February 17, 2012 elections; and after having been sworn to in accordance with law, hereby state the following: 1.) My name is My gender is 4.) My age is 3.)  ____ Male Male ____  Female Female  __________  Last  Last Name: 5.) My date of birth is  __ __ - __ __ - __ __ __ __  First Name: (Month)

(Day)

(Year)

 Middle Name:

I am generally or popularly known by the nickname or stagename

2.)

ndicate one nickname (I ndicate or stagename)

6.) My place of birth is C ity/Municipality: ity/Municipality:

_________________________________________ 

 P rovince: rovince: ________________________________________________ 

8.) My civil status is

7.) I am officially nominated by

 _____  (S ingle) ingle) _____  (W idow/er) idow/er)  _____  (   Married) (Legally (Legally _____  S eparated) eparated)  _____  (Annulled/Divorced) (Annulled/Divorced)  Full name of spouse, if married:

8.) (  P olitical  olitical  P arty)

9.) My official residence is 9.2 C ity ity 9.4

9.1  P rovince rovince

______________________________________________________ 

/ Municipality ____________________________________ 

9.3

Barangay _______________________________________ 

10.) My profession/occupation is

House No . / S  / S treet treet / S  / S ubdivision ubdivision _____________________________________________________________________________ 

12.) My contact details are

11.) My Parents are  Mother¶s Maiden Name: _____________________________________________ 

C ontact ontact

Number: ___________________________  C ontact ontact

Number: _________________________________________ 

Occupation: __________________________   Address:  Address: _____________________________________________________________    Fathers¶ Name:____________________________________________________ 

C ontact ontact

Number: ___________________________ 

  Facebook Email  Address:  Address: __________________________________ 

Occupation: __________________________   Address:  Address: ______________________________________________________________ 

13.) I will run because  _____________________________________________________________________   _____________________________________________________________________   _____________________________________________________________________   _____________________________________________________________________   _____________________________________________________________________   _____________________________________________________________________  14.) Some of my achievements in High School are  _____________________________________________________________________   _____________________________________________________________________   _____________________________________________________________________   _____________________________________________________________________   I  hereby

15.) I

am a student of Nabunturan Comprehensive High School.

16.) I am a natural born Filipino Citizen. 17.) I am eligible for the office I seek to be elected to. 18.) I will support and defend the Constitution and By   ± Laws of the Supreme Student Government of  Formon National High School and will maintain true faith and allegiance thereto. I will obey the laws, legal orders and decrees promulgated by the duly constituted authorities. I impose this obligation upon myself voluntarily, without mental reservation or purpose of evasion.

certify that the facts stated herein are true and correct of my own personal knowledge.

 ______________________________________  S ignature ignature of  C andidate andidate Over  P rinted rinted Name

 ______________________________________  S ection ection / C urriculum urriculum

 ______________________________________   Adviser   Adviser 

 

Meljohn D. Cielo SSG COMELEC Chairperson

Endorsed:

Approved: Jhames Kenneth Perez

SSG President

National

Erwin Ilao

SSG Adviser