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NATIONAL YOUTH PARLIAMENT November 5-8, 2010 APPLICATION FORM This form may be reproduced Region: Print
NATIONAL
YOUTH
PARLIAMENT
November 5-8, 2010
APPLICATION FORM
This form may be reproduced
Region:
Print legibly. Shade appropriate “
“.
1.
PERSONAL INFORMATION
Name S
2x2
Last Name
First Name
Middle Name
Date of Birth
Age
Sex
Religion
mm/dd/yy
Official Mailing Address
E-mail Address
CATEGORY OF DELEGATES
Contact Number
In school Youth
Landline
Mobile phone
Out-of school Youth
Allergies
Working Youth
2.
EDUCATIONAL BACKGROUND
Specific Youth
Groups/Youth with
Special Needs
Name of Schools /
Highest Level
Inclusive Dates
Sangguniang
Kabataan
College /
University
Attained

High School

College

Vocational

Post Graduate

3. ORGANIZATIONAL MEMBERSHIP (* Please attach additional sheet if necessary)

Organization

Inclusive Dates

Position Held

4. INVOLVEMENT IN YOUTH/COMMUNITY RELATED ACTIVITIES (* Please attach additional sheet if

necessary)

Inclusive Dates

Inclusive Dates
Inclusive Dates Description
Inclusive Dates Description
Inclusive Dates Description
Inclusive Dates Description
Inclusive Dates Description
Inclusive Dates Description
Inclusive Dates Description

Description

Inclusive Dates Description
Inclusive Dates Description

5. HOW DID YOU KNOW ABOUT NYP?

5. HOW DID YOU KNOW ABOUT NYP? Newspaper Magazine Internet Others:

Newspaper

5. HOW DID YOU KNOW ABOUT NYP? Newspaper Magazine Internet Others:

Magazine

5. HOW DID YOU KNOW ABOUT NYP? Newspaper Magazine Internet Others:

Internet

5. HOW DID YOU KNOW ABOUT NYP? Newspaper Magazine Internet Others:

Others:

6. DO YOU HAVE KNOWLEDGE IN PARLIAMENTARY PROCEDURES?

6. DO YOU HAVE KNOWLEDGE IN PARLIAMENTARY PROCEDURES? Yes No

Yes

6. DO YOU HAVE KNOWLEDGE IN PARLIAMENTARY PROCEDURES? Yes No

No

7. HAVE YOU BEEN INVOLVED IN ANY NYC PROGRAMS OR ACTIVITIES?

7. HAVE YOU BEEN INVOLVED IN ANY NYC PROGRAMS OR ACTIVITIES? Yes No

Yes

7. HAVE YOU BEEN INVOLVED IN ANY NYC PROGRAMS OR ACTIVITIES? Yes No

No

Name of NYC Program

Involvement

 

Inclusive Dates

 

8. HAVE YOU EVER BEEN CONVICTED OF ANY CRIME INVOLVING MORAL TURPITUDE?

8. HAVE YOU EVER BEEN CONVICTED OF ANY CRIME INVOLVING MORAL TURPITUDE? Yes No

Yes

8. HAVE YOU EVER BEEN CONVICTED OF ANY CRIME INVOLVING MORAL TURPITUDE? Yes No

No

9. DO YOU HAVE ANY PENDING CASE (S) IN COURT?

9. DO YOU HAVE ANY PENDING CASE (S) IN COURT? Yes No

Yes

9. DO YOU HAVE ANY PENDING CASE (S) IN COURT? Yes No

No

10.

COMMITTEE MEMBERSHIP (Pls. rank according to top 4 priority, where 1 is the highest priority)

 

Sustainable Development

 

Employment/Entrepreneurship

 

Education

 

Participation

 

Health

 

Values

 

Special Needs

 

Other relevant and emerging youth issues:

PARENTAL CONSENT (for below 18 years old)

, understand and that I have read the information provided above and decided to allow my child to participate.

I,

mother, father, legal guardian of Ms./Mr

do hereby

Signature over printed name

CERTIFICATION

I hereby certify that all facts and information indicated herein are true and correct to the best of my knowledge. I further declare that any information given by me, which is untrue, may constitute a ground for expulsion in the National Youth Parliament and prosecution of perjury.

Further, I subscribe and agree that the National Youth Commission has the sole prerogative to select and nominate the delegate to the NYP, and its decision is final and executory.

I am willing to shoulder my transportation/travelling expenses necessary to facilitate my participation to the activity.

Date accomplished

Signature of applicant

QUALIFICATIONS OF APPLICANT

APPLICATION REQUIREMENTS

Filipino citizen, between 15 to 30 years old as of June 30, 2010

Applicant must secure copies of the following:

8 copies of application letter

Able to read and write

8 copies of accomplished NYP application form with 2x2 pictures attached to each form

1 Self-addressed mailing envelope, with twenty (20) pesos (Php 20.00) worth of stamps

Residing in at the place for not less than six (6) months at the time of submission

Must be an officer of a youth organization or youth-serving institution

Of good moral character

1 original and 7 photocopies of Birth Certificate

1 original and 7 photocopies of Barangay Clearance

Has not been convicted of any crime involving moral turpitude

1 original and 7 photocopies of Certification from youth organization/institution represented

8 copies of Proposed resolution

DEADLINE IS JUNE 30, 2010

Mail or hand-carry your application to Mr. Rudyboy R. Sinay, National Youth Commission, 4/F Bookman Bldg., 373 Quezon Avenue, Quezon City Contact Number: 781-1406

8 th NYP Resolutions Template

8 t h National Youth Parliament

8 th National Youth Parliament

Name

 

Region

 

Youth Issue

 

Resolution