OWWA Scholarship Form V-2.

0
2018 Revision (Not For Sale)

Republic of the Philippines

OVERSEAS WORKERS WELFARE ADMINISTRATION 2x2
Regional Welfare Office 3 ID PICTURE

Education for Development Scholarship Program (EDSP)

APPLICATION FORM

Instructions: Fill in all the required information. Do not leave an item blank. If item is not applicable, indicate "N/A".
I. PERSONAL INFORMATION

Name
(Last Name) (First Name) (Middle Name) (Suffix)
Permanent Address

Present Address

Age Gender □ Male □ Female Name of OFW Member:

Date of Birth

Place of Birth Tel. No. Relationship to OFW:

Religion CP No. Category □ Landbased

Citizenship E-mail □ Seabased

II. FAMILY BACKGROUND
Father: □ Living □ Deceased Mother: □ Living □ Deceased No. of Siblings:

Name Address

Occupation Contact No.:

Educational Attainment E-mail:

III. EDUCATIONAL BACKGROUND

PERIOD OF ATTENDANCE
LEVEL NAME OF SCHOOL ACADEMIC AWARDS/SCHOLARSHIPS
FROM TO

Elementary

High School

College
IV. SCHOLARSHIP APPLICATION INFORMATION
School Intended to Enroll In

Course Year Level:

I hereby declare that the above information are true, correct and complete statement in compliance to policies and guidelines that governs the
OWWA Scholarship Program. I authorize the agency head or its authorized representative to verify/validate the contents stated herein.
I agree that any misrepresentation made in this document and its attachments shall cause the forfeiture of my scholarship application and/or grant.

(Signature over Printed Name of Applicant) (Date Accomplished)

V. EVALUATION (For OWWA )
Documents Attached:

□ OWWA Membership Information Sheet □ Health Certificate

□ 2"x2" recent and identical photos (3 pcs) □ Certificate of Good Moral Character
□ Proof of relationship to OWWA-Member/OFW □ Principal's Certification (For Incoming Grade 12 only)
□ Authenticated Birth Certificate (PSA) of applicant, if child of OFW (Original copy) □ Applicant's Certification
□ Authenticated Birth Certificate (PSA) of both applicant and OFW, if brother/sister of OFW □ Parent's Certification
□ Certificate of No Marriage (PSA) of OFW, if OFW is unmarried □ Course Curriculum
□ Form 137 (Certified True Copy) (For Incoming Grade 12 only) □ Grading System
□ Transcript of Records (Certified True Copy) □ Certificate of Registration
General Weighted Average (GWA) not lower than 85% in all academic and non-academic subjects during
the last school year attended in full load. (No failing grade) (For 2nd - 5th Year only)

Evaluated by: Recommending Approval: Approved by:

__________________________________ __________________________________ _________________________________

Evaluator, Education and Training Unit Chief, Programs and Services Division Officer-in-Charge, OWWA RWO3
FORM 2
A. HEALTH CERTIFICATE

HEALTH AGENCY : _______________________________________________

ADDRESS: : _______________________________________________
________________________________________________
DATE: _____________

TO WHOM IT MAY CONERN:

This is to certify that I have examined _____________________________
and found him/her to be:

Physically fit
Physically unfit

for scholarship application.

This certification is issued in connection with his/her application for the Education for Development Scholarship
Program (EDSP) of the Overseas Workers Welfare Administration (OWWA) for the S.Y. ______________________.

_____________________________
Medical Officer
(Signature Over Printed Name)
LC #: ________________________

B. CERTIFICATE OF GOOD MORAL CHARACTER

This is to certify that ________________________________ is of good moral character and that no disciplinary
action has been taken against him/her as of date.

_____________________________
Principal / Guidance Counselor
(Signature Over Printed Name)
 C. PRINCIPAL'S CERTIFICATION

Name of High School : ___________________________________________________________________

Address: ______________________________________________________________________________

TO WHOM IT MAY CONCERN:

This is to certify that __________________________________________________ is a candidate for graduation
for the school year 2019-2020 and is classified within the upper 20% of the total ________________ graduating students.

Principal
(Signature Over Printed Name)

D. APPLICANT'S CERTIFICATION

TO WHOM IT MAY CONCERN:

This is to certify that undersigned has not previously taken the EDSP Scholarship Qualifying Examination
and any post-secondary or undergraduate/college units(Incoming First Year) .

This is to further certify that NO ONE of my children has previously availed of the ODSP/EDSP/CMWSP.

Attested by:

_____________________________ _____________________________
Parent/Guardian Applicant
(Signature Over Printed Name) (Signature Over Printed Name)

E. PARENT'S CERTIFICATION

PARENT'S CERTIFICATION ON APPLICATION

FOR IMMIGRATION / NO DUAL CITIZENSHIP OF APPLICANT

TO WHOM IT MAY CONCERN:

This is to certify that my son/daughter ________________________________________________ is not a
holder of dual citizenship and has no pending application for immigration for the USA or any other country.

_____________________________
Parent/Guardian
(Signature Over Printed Name)