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OFFICE OF THE MAYOR

Taguig City, Philippines Recent


2x2
ID Picture
LIFELINE ASSISTANCE FOR NEIGHBORS IN-NEED (taken in the last 6
SCHOLARSHIP APPLICATION FORM months)
Basic/SUC-LCU/Basic + SUC/LCU
Instruction:
1. PRINT all entries. Place an X in the appropriate blanks.
2. Be HONEST and ACCURATE with your answers. Date:_____________________________

SCHOLARSHIP APPLIED FOR


____ Basic Scholarship ____ Basic Plus ____ SUC/LCU

____ New Applicant _____ Renewing Scholarship (No. of Semesters that you have benefited from the Scholarship _____________

Graduates of public high schools in Taguig or nearby LGUs in the NCR, who are enrolled or
Basic Plus
enrolling in an SUC or LCU in the NCR.
Graduate of private school in Taguig or nearby LGUs in the NCR, who are enrolled or enrolling in
SUC/LCU
an SUC or LCUs in the NCR.
Graduate of any public high school in Taguig or nearby LGUs in the NCR who are enrolled in any
Basic
private college or university, or in any accredited technical-vocational institution in the NCR.
1. Please provide 2 (two) sets of all the documents. All photocopied documents should be faithful reproduction of the original.
Bring the original copies of documents for validation purposes. Ask for the Receiving Copy upon submission.
2. Fill up ALL the data requirements in the Application Form and submit ALL the documents required during the Application.
Incompletely filled-up Scholarship Application Forms or those with incomplete requirements shall NOT be accepted, or IF
inadvertently accepted, it shall NOT be processed.
3. Submit your Scholarship Application at the l.A.N.I. Scholarship Secretariat Office at the Sen. Renato Compaero Cayetano
Memorial Science and Technology High School (Cayetano Science), Pamayanang Diego Silang, Brgy. Ususan, Taguig City,
during the application period ONLY. Check the Scholarship (Taguig) FB Account and www. taguig.gov.ph regularly for
announcement regarding dates and venue.
4. Please do NOT wait for the last day of the application period if you do not want to be inconvenienced, or worse rejected.

CHECKLIST OF REQUIREMENTS TO BE SUBMITTED


_____ Filled-up Application Form with 2X2 Recent Picture _____ Other necessary documents to facilitate the
_____ Enrolment Form for Current Semester/Term with processing of your scholarship application
Official Receipt, if applicable (Transcript or True Copy of Grades since
_____ Authenticated or True Copy of Grades last semester, start of college for New Applicants who are
with school seal/official signature (for trimester, grades continuing students, Scholarship Voucher,
for the past 2 terms) EVS Certification, F137, Course Curriculum,
_____ High School Report Card/Other valid proof of having Birth Certificate, etc.)
graduated from High School _____ Voters Certification issued by COMELEC,
(for Freshmen/New Applicants) showing that at least one of the parents of the
_____ Certificate of Good Moral Character applicant is a registered voter (Issued after the
(Issued within the school year) May 9,2016 election)
_____ School ID (back to back photocopy in a single page) _____ Voter's Certification of the applicant
(for those 18 years old and above)

PERSONAL INFORMATION

Full Name: ____________________________________________________________________________________________________________________


(Last Name) (First Name) (Middle Name)
Address: ___________________________________________________________________ Barangay: _______________________________________
District (1 or 2): ______ Years of Residency in Taguig (applicant): __________ Age: ___________ Gender: ____________________
E-mail Address: ___________________________________ Contact No.: _____________________ Religion: ___________________________
Date of Birth:______________________________ Place of Birth: _______________________________ Marital Status: _____________________
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:

COURSE and SCHOOL

Course: ___________________________________________________________Year Level: __________ GW Ave. last sem:_________________


School:___________________________________________________________________________________________________________________________
School Address: ________________________________________________________________________________________________________________
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? _________________

EDUCATIONAL BACKGROUND
School Year
Type Started Honors/Awards
Name of Schools Attended (Indicate if School Address Year Received
Public or Graduated (if any)
Private)
High School

Elementary

FAMILY BACKGROUND
FATHER MOTHER HUSBAND/WIFE
( ) Living ( ) Deceased ( ) Living ( ) Deceased (If Married)
Name
Address
Contact No.
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:
Age Marital Highest Educational If working, indicate where they
Status Attainment work & their average monthly
Name (M or S) (as of date) income

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.

I also understand that this submission of application does NOT automatically qualify me for the scholarship grant and
that I will abide by the decision of the L.A.N.I. Scholarship Management.

Thank you so much.

_____________________________________________________________
Printed Name & Signature of Applicant
Date: ____________________________________________________

Attested by:

__________________________________________________________________ Date: __________________________________________


Printed Name & Signature of Parent/Legal Guardian

Investing in education, investing in the Citys Foundation!