UC Secretariat

c/o Graduate Education and Institutional Development Department

Southeast Asian Regional Center for Graduate Study and Research in Agriculture (SEARCA)
Los Baños, Laguna 4031 Philippines | Tel. +63-49 5362290 loc 2200
Email: mcnc@searca.org | Website: http://searca.org/ucweb/

UNIVERSITY CONSORTIUM STUDENT THESIS GRANT

APPLICATION FORM

I. GENERAL INFORMATION
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1. Name of Applicant: _________________________________________________________

2. Home Address: _____________________________________________________________
3. Contact No.: _________________________ Email Address: ________________________
4. Nationality: __________________________ Passport No.: __________________________
5. Home University: ___________________________________________________________
6. Degree Program and Specialization: ____________________________________________
7. Thesis Title: _______________________________________________________________
__________________________________________________________________________
8. Name of Thesis Supervisor: ___________________________________________________
9. Total Amount of Thesis Budgetary Requirement: __________________________________
10. Amount Requested from the University Consortium _______________________________
11. Amount obtained from other sources, if any (please indicate the source of funding):
__________________________________________________________________________

II. DOCUMENTS ATTACHED: (Please check)

Letter of Application

Thesis proposal and budgetary requirements, duly approved by Advisory Committee and by the
Dean of the Graduate School

Certification or proof of financial support from other sources, if any

Signature of Applicant: _______________________________ Date Filed: __________________

Endorsed by: __________________________________

Name and Signature of UC Coordinator

To Applicant: Submit duly accomplished form together with supporting documents to the UC Coordinator of your university. List of
UC Coordinators and contact details may be found at http://searca.org/ucweb/about-uc/directory-officials.