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GN Watershed Scholarship Program Form 1

This document appears to be an application for a watershed scholarship program offered by the municipality of General Nakar in the province of Quezon, Philippines. It requests personal information from applicants such as name, birthdate, address, family details, and school information. It outlines both general and documentary requirements to qualify for the scholarship. The general requirements include being a natural-born Filipino resident of General Nakar with a certain length of residency, academic performance, and moral character. The documentary requirements include certificates, transcripts, and other documents to verify information and eligibility. The scholarship would cover tuition, living allowance, and learning materials for qualified applicants.

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lykaorozco091306
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22 views

GN Watershed Scholarship Program Form 1

This document appears to be an application for a watershed scholarship program offered by the municipality of General Nakar in the province of Quezon, Philippines. It requests personal information from applicants such as name, birthdate, address, family details, and school information. It outlines both general and documentary requirements to qualify for the scholarship. The general requirements include being a natural-born Filipino resident of General Nakar with a certain length of residency, academic performance, and moral character. The documentary requirements include certificates, transcripts, and other documents to verify information and eligibility. The scholarship would cover tuition, living allowance, and learning materials for qualified applicants.

Uploaded by

lykaorozco091306
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines

MUNICIPALITY OF GENERAL NAKAR


Province of Quezon

PASSPORT SIZE
ID PICTURE

GENERAL NAKAR
WATERSHED SCHOLARSHIP PROGRAM

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

(Last Name) (First Name) (Middle Name)


Permanent Mailing
Date of Birth (mm/dd/yyyy)
Address
Place of Birth
Sex  Male  Female Zip Code
Civil Status
 Single School Name
School Address
 Married

Citizenship School Type ( )Public ( )Private

Mobile Number Highest Grade/Year

E-mail Address Year Graduated

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

Name
Address
Occupation
Educational Attainment
Total Parents Gross Income No. of Siblings in the family

School Intended to enroll in:


School Address:
Type of School: ( ) Public ( ) Private
Course: ( ) Priority ( ) Non-Priority

(Signature over Printed Name of Applicant) Date Accomplished


Note: Fully accomplished form to be submitted to the GNSIAD Project Office.
DO NOT FILL-OUT THIS PORTION (FOR GNSIAD USE ONLY)

Belongs to:
Applicant is Qualified for: Scholarship Privileges:
(Geographically Isolated and Disadvantaged Areas)
Watershed Scholarship Tuition Fees
Program Kaliwa
Grants-In-Aid Living Allowance P 25,000.00 x 2 Semester / School Year
Kanan
Student Loan Learning Materials and/or
Umiray Watersheds
Connectivity Allowance
Dumagat-Remontado (IPs)

Evaluated/Processed by:

GNSIAD Officer

GENERAL REQUIREMENTS DOCUMENTARY REQUIREMENTS


1. Must be natural-born Filipinos of good moral character and 1. Certificate of Good Moral Character and Police Clearance
2. Certificate of Good Health
in good health and a resident of General Nakar, Quezon.
3. Principals Certification
2. Residing within Kaliwa, Kanan and Umiray Watersheds as Graduating Grade 12 male and female Students in SY 2023 – 2024
Graduate of Grade 12 before 2023 – 2024 and did not enroll in college yet
attested by the barangay for at least four (4) years; Or Graduate of High School before K12 Program. Must belong to the top 10% of the graduating class
member of Forest dependent families in Geographically Applicant who is under the Alternative Learning System
Isolated Disadvantage Areas (GIDA) of General Nakar. Or 4. Certificate of Residency (Barangay)
5. Certificate from NCIP (If member of Dumagat-Remontado IPs)
Member of Dumagat-Remontado (IPs) as attested by NCIP; 6. Scholarship Examination/Award Certificate
7. Signed Declaration of Applicant and the Parent/Legal Guardian (Kasunduan)
3. Graduating Grade 12 male and female Students in SY 2023 – 2024 8. Certified Copy of Permanent Student Record (Form 137) or Report Card (Form 138) for Grades 9, 10 and 11
or Graduate of Grade 12 before 2023 – 2024 and did not enroll or Philippine Equivalency Placement Test Certificate of Rating
in college yet; or Graduate of High School before K12 Program. or For Grades 9 and 11: Accreditation and Equivalency Test Certificate of Rating
Must belong to the top 10% of the graduating class. or Certificate of Completion from ALS Teacher
9. Recent picture, passport size (4.5 cm x 3.5 cm or 1.8 inches x 1.4 inches)
4. Of good moral character, no criminal records and in good health; 10. Birth Certificate
5. Must have a general weighted average of at least 85% or its 11. Parent/s or Legal Guardian’s 2021 Income Tax Return / BIR Form 1701 / Employment Contract for OFW / BIR Certificate of
equivalent and with no conditional or failing mark; Exemption from Filing of ITR / Certificate of Indigency / Certificate of Employment with Compensation / Proof of Pension
12. Notarized Affidavit of Guardianship if applicable
5. Must pass the panel interview by the selection committee. 13. Interview Result

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