UniFAST TDP Form Annex 1

2022 version

(NOT FOR SALE)

CHED Regional Office

2x2
UniFAST TULONG DUNONG PROGRAM (UniFAST-TDP) ID PICTURE
APPLICATION FORM
Instructions. Read General and Documentary Requirements. Fill in all the required information. Do not leave an item blank Item is not applicable, indicate "NA".

PERSONAL INFORMATION

Lasit Arnold Cagabhion

Name (Last Name) (First Name) (Middle Name) Maiden Name
(for Married Women)

Date ofBirth Permanent Address Zip Code

(mm/dd/yyyy) December 28,2001

1026, Hulo Bulakan Bulacan
street , Brgy.
Rodriguez,Rizal Balubad,Bulak
Place of Birth
an,Bulacan 3017
Street & Town/City/ Province

Barangay Municipality

Name of School Attended

/ Male School ID Number 2021400939

Sex
Female School Address TJS Matungao,Bulakan,Bulacan
Citizenship Fil School Sector (/ ) Public ( ) Private

Mobile 09489353351 Year Level 3rd year Tribal Membership

Number
(if applicable)

E-mail [email protected] Type of Disability

Address (if applicable)

FAMILY BACKGROUND

Father: (/) Living () Deceased Mother: (/) Living ( ) Deceased

Name Danilo C. Lasit Antonia C.Lasit

Address 1026, Hulo street , Brgy. 1026, Hulo street , Brgy.
Balubad,Bulakan,Bulacan Balubad,Bulakan,Bulacan

Occupation Tricycle Driver Factory worker

Total Parents Gross income 800 per day No. of Siblings in the family

Are you enjoying other educational financial assistance? __Yes or / No

If yes, please specify 1.

2.
_____________________________

I hereby certify that foregoing statements are true and correct.

Arnold C. Lasit February 8 2024

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 CHEDRO USE ONLY)

UniFAST TDP Form Annex 1
2022 version

(NOT FOR SALE)

CHED Regional Office

2x2
UniFAST TULONG DUNONG PROGRAM (UniFAST-TDP) ID PICTURE
APPLICATION FORM
Instructions. Read General and Documentary Requirements. Fill in all the required information. Do not leave an item blank Item is not applicable, indicate "NA".

Documents Attached
Certificate of Registration/Enrolment (CORs/COEs)
Certificate of Indigency

Evaluated Processed by:

______________________________
UniFAST Regional Coordinator

QUALIFICATION REQUIREMENTS DOCUMENTARY REQUIREMENTS per Section 3 of the Memorandum Circular No. __ s.
2022. 6.2.1 a. For new applicants:
per Section 1 of the Memorandum Circular
No. __ s. 2022. Participating higher education institutions (HEIs) must submit, to the
respective CHED Regional Offices, a certified true copy or electronically-generated copy of the
An applicant for this grant must be a Filipino list of enrolled student- applicants with total number of units enrolled (Annex 5), with the
citizen with a combined household attached certified electronically generated Certificate of Registration/Enrolment (CORs/COEs)
(parents/guardian) gross income which shall not as proof of enrollment.
exceed Four Hundred Thousand Pesos
(PhP400,000.00) and maybe classified as 6.2.2 (Income Requirement) New applicants and continuing grantees shall submit a
one of the following: Certificate of Indigency as proof of income, duly issued by the Punong Barangay where the
applicant resides.
5.1 New TDP-TES Grantee must be
enrolled
in any first undergraduate degree in

SUCs, CHED-Recognized LUCs and Private

HEIs that are in the CHED Registry of
Programs and Institutions.
UniFAST TDP Form Annex 1
2022 version

(NOT FOR SALE)

CHED Regional Office

2x2
UniFAST TULONG DUNONG PROGRAM (UniFAST-TDP) ID PICTURE
APPLICATION FORM
Instructions. Read General and Documentary Requirements. Fill in all the required information. Do not leave an item blank Item is not applicable, indicate "NA".
UniFAST TDP Form Annex 1
2022 version

(NOT FOR SALE)

CHED Regional Office

2x2
UniFAST TULONG DUNONG PROGRAM (UniFAST-TDP) ID PICTURE
APPLICATION FORM
Instructions. Read General and Documentary Requirements. Fill in all the required information. Do not leave an item blank Item is not applicable, indicate "NA".
UniFAST TDP Form Annex 1
2022 version

(NOT FOR SALE)

CHED Regional Office

2x2
UniFAST TULONG DUNONG PROGRAM (UniFAST-TDP) ID PICTURE
APPLICATION FORM
Instructions. Read General and Documentary Requirements. Fill in all the required information. Do not leave an item blank Item is not applicable, indicate "NA".