Revised StuFAPs FORM NO.

1
2014 version (NOT FOR SALE)
Office of the President of the Philippines
COMMISSION ON HIGHER EDUCATION
REGIONAL OFFICE ____ 2X2
ID PICTURE

CHED STUDENT FINANCIAL ASSISTANCE PROGRAMS (StuFAPs)

APPLICATION FORM

Instructions: Please read the General and Documentary Requirements. Fill in all the required information. Do not leave an item blank. If item is not applicable, indicate "N/A".

PERSONAL INFORMATION
Name
Romero Harjay Deang
(Last Name) (First Name) (Middle Name)
11/20/00 Permanent Mailing Blk. 41 Lot 18, Brgy. Cristo Rey, Capas, Tarlac
Date of Birth (mm/dd/yy)
Address
Place of Birth Concepcion, Tarlac
Sex  Male  Female Zip Code 2315
Civil Status
 Single School Name Dominican College of Tarlac
School Address
 Married Sto Rosario, Capas 2315, Tarlac

Citizenship Filipino School Type ( )Public ( )Private

Mobile Number 0908 997 1740 Highest Grade/Year
E-mail Address [email protected] Type of Disability (if applicable)

FAMILY BACKGROUND
Father: ( ) Living ( ) Deceased Mother: ( ) Living ( ) Deceased

Name Virgilio D. Romero Catalina D. Romero

Address Blk. 41 Lot 18, Brgy. Cristo Rey, Capas, Tarlac Blk. 41 Lot 18, Brgy. Cristo Rey, Capas, Tarlac
Occupation Foreman Housewife
Educational Attainment High School Graduate High School Graduate
Total Parents Gross Income ₱15,000 No. of Siblings in the family Three (3)

School Intended to enroll in Tarlac State University

School Address: Romulo Blvd. San Vicente Tarlac City
Type of School: ( ) Public ( ) Private
Course: BS Accountancy ( ) Priority ( ) Non-Priority

Harjay Deang Romero

(Signature over Printed Name of Applicant) Date Accomplished

Note: Fully accomplished form to be submitted to the CHEDRO

DO NOT FILL-OUT THIS PORTION (FOR CHED USE ONLY)

Applicant is Qualified for: Belongs to: (any of the following groups) Documents Attached: Equivalent Points
Scholarship solo parent and their dependents Form 138 =
Grants-In-Aid senior citizens Latest ITR P =
Student Loan persons with disabilities Total
indigenous and ethnic peoples

Evaluated/Processed by:

CHED StuFAP Coordinator

GENERAL REQUIREMENTS DOCUMENTARY REQUIREMENTS
1. Must be a Filipino citizen; Academic Requirement:
2. Must be a high school graduate; candidate for A. For Incoming Freshmen
graduation; with earned units in college; 1. For fourth year high school applicants - third year grades and first three grading periods of fourth year;
passer of ALS/PEPT; 2. For high school graduates - Form 138
3. Must have a combined annual gross income of B. For Applicants with Earned Units in College
parents/guardian not to exceed Three Hundred 1. Certificate of grades in all subjects in the last two (2) semesters
Thousand Pesos (P300,000.00).* C. For Other Applicants
4. Must avail only one CHED scholarship or financial 1. ALS - Accreditation and Equivalency Test Passer Certificate
assistance program; and 2. PEPT - Certificate of Advancing to the Next Level
5. Must not be a graduate of any degree program. OTHER REQUIREMENTS:
A. Any one of the following: Latest Income Tax Return (ITR) of parents or guardian, Certificate of Tax Exemption from
*In highly exceptional cases where income exceeds PhP300,000.00, the the Bureau of Internal Revenue (BIR) Certificate of Indigency from their Barangay, Case Study from Department of
CHEDRO StuFAPs Committee shall determine the merits of the application.
Social Welfare and Development (DSWD), or Affidavit of No Income
B. Certificate of good moral character from the last school attended.
 CHED Priority Courses for AY 2014-2015 to AY 2017-2018
CHED Memorandum Order (CMO) No. 01, s. 2014

Information Technology Science and Math

Information Technology and Computing Studies BS Math
Multimedia BS Physics
Animation BS Biology
Programming BS Chemistry
Computer Science BS Marine Biology/Science
Information System Management BS Applied Physics
Bachelor in Library Science and BS Geology
Information System Major in System Analysis BS Earth Science
BS Applied Mathematics
Agriculture and Related Fields BS Statistics/Applied Statistics
Agro Forestry Atmospheric Science
Veterinary Medicine Environmental Science
Agricultural Engineering
Agribusiness/Management Health Sciences
Agricultural Entrepreneurship Pharmacy
Agricultural Technology Radiology Technology
Agriculture Medical Technology
Fisheries Physical Therapy
BS Food Technology BS Nutrition
Agricultural Economics
Arts and Humanities
Teacher Education major in Creative and Performing Arts
Math BS Religious Education
Science BS Philosophy
Physics BS Theology
Chemistry
Reading Social and Behavioral Sciences
English BS Psychology
Educational Media/Technology BS Social Work
Special Education (SPED) Human Development
Human Kinetics Guidance and Counselling
Physical Education and Sports Science
Bachelor of Physical Education major in School PE Business Administration and related courses
Early Childhood Education BS Accountancy
Environmental Planning (for Teachers) Business Data Outsourcing
MAPEH Business Process Outsourcing
Music Education Construction Management
Art Education Tourism
Health Education
Architecture
Engineering BS Architecture
Mechanical Landscape Architecture
Electronics Interior Design
Communication Environmental Planning
Metallurgical/Mining Fine Arts
Computer Urban Planning
Biomedical
Chemical Maritime
Geodetic BS Marine Transportation
Electrical
Meteorological Communication
Mining BA Communication
Geological BA Journalism
Sanitary Engineering BA Broadcasting
Chemical Engineering BS Development Communication
Industrial Engineering
Civil Engineering Others (to be determined by the Region)
Electronics and Communication Engineering
Petroleum Engineering
Bio Chemical Engineering