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  • Lueasp Application

    Transféré par

    Jenny Rillera Hernaez
    55 vues3 pages
    This document is a scholarship application form that collects personal, educational, and family information. It requests the applicant's name, address, date of birth, education history, intended course of study, work and income information. It also collects information about the applicant's family, including parents' education and employment, household assets and income sources, property owned, and appliances in the home. The applicant and their parent/guardian must sign certifying the truthfulness of the information provided, with acknowledgement that false information could disqualify the applicant from receiving financial assistance.

    Description originale:

    hahab

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    This document is a scholarship application form that collects personal, educational, and family information. It requests the applicant's name, address, date of birth, education history, intended course of study, work and income information. It also collects information about the applicant's family, including parents' education and employment, household assets and income sources, property owned, and appliances in the home. The applicant and their parent/guardian must sign certifying the truthfulness of the information provided, with acknowledgement that false information could disqualify the applicant from receiving financial assistance.

    Droits d'auteur :

    © All Rights Reserved
    Téléchargez comme XLS, PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    55 vues3 pages

    Lueasp Application

    Transféré par

    Jenny Rillera Hernaez
    This document is a scholarship application form that collects personal, educational, and family information. It requests the applicant's name, address, date of birth, education history, intended course of study, work and income information. It also collects information about the applicant's family, including parents' education and employment, household assets and income sources, property owned, and appliances in the home. The applicant and their parent/guardian must sign certifying the truthfulness of the information provided, with acknowledgement that false information could disqualify the applicant from receiving financial assistance.

    Droits d'auteur :

    © All Rights Reserved
    Téléchargez comme XLS, PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    sur 3

    SCHOLARSHIP PROGRAM

    APPLICATION FORM Photo


    (2004 Revised Edition)

    I PERSONAL DATA

    NAME
    (Family Name) (First Name) (Middle Name)
    COMPLETE POSTAL ADDRESS

    DATE OF BIRTH Place of Birth

    AGE Sex Civil Status Religion

    II EDUCATIONAL DATA

    LEVEL NAME & ADDRESS OF SCHOOL YEARS OF HONORS/AWARDS


    ATTENDANCE RECEIVED
    Elementary

    Secondary

    COURSE YOU INTEND TO ENROLL YR/LEVEL WEIGHTED AVERAGE

    NAME & ADDRESS OF SCHOOL

    ARE YOU A WORKING STUDENT? IF YES, HOW MUCH DO YOU RECEIVE?

    WHAT IS THE BIGGEST SOURCE OF INCOME OF THE HOUSEHOLD? `

    Business Dividends/Interest/Earnings/Investment
    Retirement Pension Salary/Wages
    Farms/Hacienda/Fishpond Remittance from abroad/Commission
    Real estate rental Others
    Practice of Profession

    Who contributes for your school expenses? How much?

    Does your family own or rents the house you live? Please Check.

    Own House (not mortgaged)


    Own House (Mortgaged); Monthly Amortization PHp__________
    Renting: Monthly Rental Php ___________
    Neither own nor rent the house
    Name of Owner
    Relationship of owner to family

    REAL ESTATE PROPERTY OWNED BY THE FAMILY

    Residential/Agricultural

    Area (in sq. m.) Location (Province/Municipality/City) Latest Assessed Value


    III FAMILY DATA

    Parents/Legal Guardians

    School Previous
    Name of Family Member Highest Degree Attended/ Present Job Gross Civil Status
    /level reached Graduated Name of Employer Designation Income of Siblings
    (Father)

    (Mother)

    (Legal Guardian)

    (Brothers/Sisters)

    Does your family owns any of the following household appliances and facilities? Don't leave any blank. Write O if your family does
    not own the appliances:

    # of working units Year Acquired


    a) Colored TV
    b) Karaoke
    c) Compact Disc
    d) Component Stereo
    e) Microwave Oven
    f) Range with Oven
    g) Air Conditioner
    h) Personal Computer
    i) VCD/DVD
    j) Cordless Phone

    IV STATEMENT OF THE APPLICANT

    I hereby certify that all the data and information which I have furnished are accurate and complete. I understand that any false
    data given , misinterpretation and concealment of material facts and/or withholding any relevant information will automatically
    disqualify me from receiving any financial assistance from the Province of La Union.

    Moreover, I understand that the scholarship Committee may send a fact-finding team to visit my home/residence to verify the
    veracity of the information provided in this application and will give my utmost cooperation in this regard.

    Applicant's Signature

    STATEMENT OF THE APPLICANT'S PARENTS OR GUARDIAN

    I hereby certify to the truthfulness and completeness of the information which my son/daughter/dependent has furnished in this
    application together with all the documents attached. I further recognize that in signing this application form, I share with my
    son/daughter/dependent the responsibility for the truthfulness and completeness of the information supplied herein.

    Parent's/Legal Guardian's Signature

    RECOMMENDING AUTHORITY:

    FRANCISCO EMMANUEL R. ORTEGA III


    Provincial Governor
    ACTION TAKEN BY SCHOLARSHIP COMMITTEE:

    REMARKS

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