TECHNOLOGICAL INSTITUTE Scholarship Qualifications TIP-CC-013 Revision Status/Date: 1/2017 DEC 01

The Senior High School graduate must:

OF THE PHILIPPINES  Possess a GWA of 85% with no grade in any subject below 83%
CAREER CENTER  Not enrolled in any college/ university prior to this examination

PRIVACY CONSENT
I understand and agree that by filling out this form I am allowing the Technological Institute of the Philippines to collect, process, use, share, and disclose my personal information for
Application for Scholarship Examination and also to store it as long as necessary for the fulfillment of the stated purpose and in accordance with applicable laws, including the Data
Privacy Act of 2012 and its Implementing Rules and Regulations, and the T.I.P. Privacy Policy. The purpose and extent of collection, use, sharing, disclosure, and storage of my personal
information was explained to me.

APPLICATION FOR SCHOLARSHIP EXAMINATION

NAME OF EXAMINATION DATE TIME PLACE Please attach

 Engr. Demetrio A. Quirino Jr. Scholarship Grant March 3, 2018
9:00 AM – 11:00
recent 2”x 2”
 Dr. Teresita U. Quirino Scholarship Grant March 10,
AM picture
2018

Please PRINT CLEARLY.

Surname First Name Middle Name Signature
Permanent Address Contact Number:

Date of Birth: Senior High School Strand : Gender :

 Male  Female
Senior High School: School Address: Type of School:
 Public  Private
General Weighted Average: Rank: Preferred Program

Checklist of Requirements Submitted: Chemical Engineering Mechanical Engineering  Architecture

 Copy of Senior High School Report Card (Form 138) or Certified Civil Engineering Marine Transportation  Education
Copy of Grades Electronics Engineering Marine Engineering Accountancy
 One (1) copy of 2” x 2” ID Picture Electrical Engineering Environmental & Sanitary
 Copy of Grade 12 School I.D. Engineering

Source of information about the Scholarship Examination - Tick () one

 Walk in Applicant  TIP Student  TIP Website/Internet

 SHS Career Orientation  TIP Alumni  Newspaper Ads
 TIP Flyer/Poster  TIP Employee  Others, specify__________________________
Examinee No. Room No. Recommended by:

Name and Signature /Date

TECHNOLOGICAL INSTITUTE TIP-CC-013

Revision Status/Date: 1/2017 DEC 01
OF THE PHILIPPINES
CAREER CENTER SCHOLARSHIP EXAMINATION PERMIT

NAME OF EXAMINATION DATE TIME PLACE

 Engr. Demetrio A. Quirino Jr. Scholarship Grant
 Dr. Teresita U. Quirino Scholarship Grant
Please PRINT CLEARLY.
Surname First Name Middle Name Examinee No. Room No.

IMPORTANT:
1. Be sure that this Examination Permit has been processed properly. 4 Books, notes and calculators are not allowed in the examination room.
2. Remember to bring this EXAMINATION PERMIT, BLACK INK BALL PEN, PENCIL 5. The examination starts promptly at 9:00 AM. You must be at your designated room
3. and GRADE 12 SCHOOL I.D. on the examination day. 30 minutes before the start of the examination.
6 Examinees who arrived late may only be admitted upon submission of a note
clearance from the Admissions and Marketing Office.
IMPORTANT: STUDENT EXAMINEE WHO FAILS TO GRADUATE IN THE CURRENT SY FORFEITS ALL PRIVILEGES OF THE SCHOLARSHIP EXAM EVEN IF HE/ SHE PASSES THE EXAM.
For inquiries, pls. call: Manila Campus: Tel. No. 733-9117/ 736-4208/ 736-2580 Quezon City Campus: Tel. No. 911-0964/ 912-1539 / 911-7199 www.tip.edu.ph