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University of San Carlos

Carolinian Working Scholars Association


Cebu City, Philippines

THE OUTSTANDING WORKING SCHOLAR AWARD 2017

Form 1: NOMINATION FORM

Respected Board of Judges:

After viewing the rules and criteria, it is my pleasure to nominate:

NAME: _______________________________
COURSE: _______________________________

As candidate in the search for THE OUTSTANDING WORKING SCHOLAR of


the University of San Carlos for the school year 2016-2017, I hereby certify that, to the
best of my knowledge, the information contained in the nomination and the
accompanying supporting documents are true and accurate. I understand that the
decision of the Board of Judges is final, and I agree to abide by it.

______________________________
(Signature over printed name)
Attester

The Outstanding Working Scholar Award 2017


FORM 2: PERSONAL DATA SHEET

Name: E-mail Address:

Course and Year: Contact Number:

Department Assigned: Mothers Name:

Age: Occupation:

Gender: Fathers Name:

Address: Occupation:

Religion: Name of Immediate Head/ Head:

Education Name of Institution/ School Highest Award Received

Elementary

High School

College

ORGANIZATIONS (INSIDE AND OUTSIDE USC)

Name of Organization Address Position Year

The Outstanding Working Scholar Award 2017


FORM 3: GRADE PRINT-OUT

The Outstanding Working Scholar Award 2017


FORM 4: Most significant Activities

Certificates, photos or any other supporting documents follow after every claim.

SUMMARY OF CO- CURRICULAR AND EXTRA-CURRICULAR INVOLVEMENT


Name of Activity Name of Organization Position/ Role Date of Activity

The Outstanding Working Scholar Award 2017


Form 5: Latest Performance Evaluation (Secure a copy from HR)
Latest Tardiness Report (Secure a copy from HR)

The Outstanding Working Scholar Award 2017


FORM 6:
AWARDS RECEIVED IN COLLEGE

Name of Award Date/Year Received

The Outstanding Working Scholar Award 2017


University of San Carlos
Carolinian Working Scholars Association
Cebu City, Philippines

THE OUTSTANDING WORKING SCHOLAR AWARD 2017


Form 7 (CHARACTER REFERENCE AND ATTESTATION)
1. Name:_______________________________________________________

Position:_____________________________________________________

Company:____________________________________________________

Contact Number:_______________________________________________

2. Name:_______________________________________________________

Position:_____________________________________________________

Company:____________________________________________________

Contact Number_______________________________________________

I certify, to the best of my knowledge, that all information presented in this application
form are accurate and true. Any misrepresentation shall automatically disqualify me
from TOWSA 2017.

__________________________________________
Applicants Signature over printed name

Date Signed: ____________________

The Outstanding Working Scholar Award 2017

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