OFFICE OF THE MAYOR

Taguig City, Philippines

Recent

L.A.N.I. SCHOLARSHIP APPLICATION FORM

2x2
ID Picture

Full/Premier/Priority

Instruction:
Second Semester SY 2014-2015
1. PRINT all entries
2. Place an X in the appropriate blank provided
Date:_____________________________

SCHOLARSHIP APPLIED FOR

____ Full Scholarship _________________________ (Honor/s Received) _____ Premier _____
Priority Courses
______ New Applicant
_______ Renewing Scholarship (Renewal for
______________________ Time)
Graduating this semester/term ____ Yes _____ No
If yes, are you graduating with honors?
______Yes _______ No
If no, how many semesters more to go before you graduate, including the current sem/term?
_________________
Premier

Full
Priority

For those enrolled in the University of the Philippines System (Luzon Campuses) &
other public & private colleges & universities certified by CHED as Centers of
Excellence in the NCR. This is open to graduates of either public or private high
schools in Taguig.
Top 10 graduates of public high schools in Taguig, regardless of the schools or
courses in college.
Those enrolling in or enrolled in DOST-listed priority courses in DOST-listed schools,
or if persons with disabilities, must be endorsed by the city PDAO, or if taking up law
or medicine, must be enrolled or enrolling in top performing schools as listed by the
program based on the listing of PRC/CHED. This is open to graduates of either public
or private high schools in Taguig.

Please provide 2 (two) sets of all the documents.

All photocopied documents to be
submitted should be faithful reproduction of the original. Bring the original copies of
documents for validation purposes. Ask for the Receiving Copy upon submission.

REQUIREMENTS TO BE SUBMITTED
_____ Filled-up Application with 2X2 Recent Picture
_____ Enrolment Form for the Current Semester/Term
with Official Receipt
_____ High School Card for Freshmen (any proof of
having
graduated from Public High School
_____ Certificate of Good Moral Character (Issued
within
the school year
_____ School ID back to back (photocopy)

_____ Authenticated Copy of Grades last sem (for

trimester
grades for the past 2 terms with school seal)
_____ Voters Certification issued by Comelec
showing that
at least one of the parents of the applicant is
a
registered voter/ Voters Certification of the
applicant (if 18 years old or above)
_____ Certificate of Academic Excellence as Full
Scholar

_____ Other necessary documents to facilitate the

processing
of your scholarship application

PERSONAL INFORMATION
Full
Name:
____________________________________________________________________________________________________
________________
(Last Name)
(First Name)
(Middle Name)

Address:
____________________________________________________________________________________________________
___________________
Barangay: _____________________________________________
E-mail
Address:
________________________________________________
Mobile Phone No.:_______________________________
Telephone No.: ________________________
Age: _________________
Date of Birth:________________________________________ Place of Birth: _______________________________
Gender: _____________
Years of Residency in Taguig (applicant): _________ Marital Status:
__________________ Religion:
____________________
Residence: ______Owned by family_____ Owned by relatives _____ Renting ____Paying-to-own
_____Others (pls specify): __________________________ If renting or paying-to-own, how much are you
paying monthly?: P_________________________
Have you been the object of any disciplinary action in school? ____Yes _____ No . Have you been
accused or convicted of any offense/crime? ____ Yes
_____ No If the answer to any of the last 2
questions above is Yes, please provide details:
____________________________________________________________________________________________________
_____________________
Acceptance of Applications for the SECOND SEMESTER SY 2014-2015
First Batch:
Nov 03 - 17, 2014
Third Batch : Feb 16 27, 2015
Second Batch: Dec 10 - 17, 2014
For TUP-Taguig Nov 05 12,
2014 only
Jan 05 14, 2015
For PUP-Taguig March 04
11, 2015 only
COURSE and SCHOOL
Course: ___________________________________________________________Year Level: __________
Ave. last sem:_____________

Grade

School:_____________________________________________________________________________________________
______________________________
School
Address:
____________________________________________________________________________________________________
____________

Name of Schools
Attended

EDUCATIONAL BACKGROUND
School
Type
(Indicate
School Address
if Public
or
Private)

Year
Started
Year
Graduat
ed

Honors/Awards
Received
(if any)

High School
Elementary

FATHER
( ) Living ( )
Deceased
Name
Address
Contact No.

FAMILY BACKGROUND
MOTHER
( ) Living ( )
Deceased

HUSBAND/WIFE
(If Married)

Occupation
Place of
Work
Highest
Educational
Attainment
Ave. Monthly
Income

Number of siblings in the family (including applicant):_______. Please fill out information below about
your siblings:
Ag Marita
Highest
If working, indicate where
e
l
Educational
they
work
&
their
Name
Status
Attainment
average monthly income
(M or S)
(as of date)

I hereby certify that ALL the answers given above are TRUE and CORRECT to the best of my
knowledge, and the attached documents are FAITHFUL REPRODUCTION of the original copies. I
further acknowledge that ANY ACT OF DISHONESTY OR FALSIFICATION MAY BE A GROUND
FOR MY DISQUALIFICATION from this scholarship program. Thank you very much.
________________________________________________
_____________
Printed Name & Signature of
Applicant
Date:
____________________________________________________
Attested by: __________________________________________________________________
___________________________
Printed Name & Signature of Parent/Legal Guardian

Investing in education, investing in the Citys Foundation!

Date: