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1 - Application Form - For Students

This document is an application form for the Faculty Scholarship for PSU Students Program at Pangasinan State University in the Philippines. It requests information such as the applicant's name, contact details, academic performance, other sources of financial assistance, work experience, extracurricular activities, and a one-page essay on how the scholarship would impact their life. Applicants must also submit documents like an enrollment form, proof of GPA, proof of indigency, and a map of their house location. The applicant signs to declare the truth and accuracy of the information provided and authorizes verification of the contents.

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Vernadette De Guzman
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44 views

1 - Application Form - For Students

This document is an application form for the Faculty Scholarship for PSU Students Program at Pangasinan State University in the Philippines. It requests information such as the applicant's name, contact details, academic performance, other sources of financial assistance, work experience, extracurricular activities, and a one-page essay on how the scholarship would impact their life. Applicants must also submit documents like an enrollment form, proof of GPA, proof of indigency, and a map of their house location. The applicant signs to declare the truth and accuracy of the information provided and authorizes verification of the contents.

Uploaded by

Vernadette De Guzman
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

PANGASINAN STATE UNIVERSITY


Lingayen, Pangasinan

FACULTY SCHOLARSHIP FOR PSU STUDENTS PROGRAM


Application Form

Date: ____________________

Name of Canditate: ___________________________________ Nickname: _______________ID #: ____________


Year, Course and Section: ______________________________________________________________________
Contact Number: ____________________________________ E-mail Ad.: ________________________________
Permanent Address: ___________________________________________________________________________
_____________________________________________________________________________
Temporary Address: ___________________________________________________________________________
_____________________________________________________________________________

Grade Point Average last Semester: _____________ SHS GPA (for first year applicant): _____________________
Academic or non-academic award/s received: _______________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

If you are expecting to receive financial assistance or scholarships from any source, please describe them. Include
the amounts expected to be received.
_____________________________________________________________________________________
_______
____________________________________________________________________________________________
____________________________________________________________________________________________

Have you filed any other scholarship program from any private institution or government agencies before:

__ Yes ___ No

If yes: a) write the name of institution you have applied to:


_________________________________________________________________
_________________________________________________________________
b) Write the grants/ aids you have received from that scholarship program
_________________________________________________________________
_________________________________________________________________
c) Write the period when you enjoyed the said scholarship grant.
_________________________________________________________________
_________________________________________________________________

Do you have a full or part-time job at the moment? ___ Yes ___ No
If yes, write the job, the schedule of work and the salary/ wage your are receiving
per month.
_________________________________________________________________
_________________________________________________________________
Describe your membership and/or leadership experience in the Campus.
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Please attach the following items to this application form:
1. A one-page essay explaining the impact of this scholarship to your life; (2) A photocopy or e-copy of your enrolment form; (3) A
certified report of rating for your GPA; (4) Proof of indigency; and (5) Sketch map of the location of your house .

I declare under oath that I have personally accomplished this Application Form which is a true, correct and complete
statement. I authorize the agency head/authorized representative to verify/validate the contents stated herein.

______________________________________
Applicant’s Signature Over Printed Name

Faculty Scholarship for PSU Students (FSPS) Program

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