CHED FACULTY DEVELOPMENT PROGRAM II Name of Applicant Scholar: ______________________________________________ Home / Sending HEI: ___________________________________________________ Program applied for:

___________________________________________________ Documents Submitted:

Document/s 1. Scholarship application form For the CHED Scholarship Application List of courses offered by SHEI* Total College/University Enrollment Certification from School Head Teaching Load Certification that grantee has no pending administrative charges Certification that grantee has no pending scholarship program being undertaken Certification of employment indicating Official Designation, Status of Employment (Full/PartTime), Tenure (Permanent, Probationary, Contractual or Temporary) and Date hired. Complied

2X2 ID Picture
(printed name at the back)

Not Complied

Date Complied

2. 3. 4. 5.

Recommendation Transcript of Records (for every course taken: BA/BS, MA/MS, units earned) Rehiring Agreement (if not permanent in SHEI) Medical Certificate Doctors Certificate (to be administered by a Government physician) Urinalysis Fecalysis Complete Blood Count X-ray result

6. 7. 8. After CHED Approval 9 10. 11. 12.

NBI or Police Clearance Birth Certificate (Issued by NSO) SHEI Institutional Faculty Plan Signed Scholarship Contract (5 copies) Co-maker Undertaking (5 copies) Income Tax Return of Co-maker Photocopy of any valid ID/Passport

*SHEI Sending Higher Education Institution