All 2016-2017 approved scholars and grantees under the Scholarships for Graduate Studies - Local (SGS-L) program

and S
respectively, are advised to migrate their existing DBP Prepaid Accounts to DBP Savings Accounts. This is consistent with t
Pilipinas to migrate all cards (credit, debit, and prepaid) into Europay, MasterCard, Visa or EMV chip cards.

Part of the requirement to open a DBP-CHED Savings Account is a CHED Certification of Scholarship/Grant. To receive the
grantees are required to answer the offline form below. This is necessary to ensure a smooth transition to EMV-Compliant S
DBP Prepaid Cards of scholars and grantees who are scheduled to finish their program/engagement before June 2018.

1. Please fill out this offline form in BLOCK LETTERS.

2. Save file as DBPMigrationOffline_(SHEI Name)_(Faculty Name).xls i.e. DBPMigrationOffline _ ABCUniversity _ Juan D
3. Submit through uploading in chedk12.com/dbpmigrationoffline together with scanned copies of the following:
a. ORIGINAL Approved Study Plan (signed by adviser and/or dean)
b. MODIFIED Approved Study Plan (signed by adviser and/or dean), if applicable

After opening a DBP-CHED Savings account, upload a scanned copy of your deposit slip at chedk12.com/dbpdepositslip
SCHOLAR PROFILE
UNID
Last Name
First Name
Middle Name
Extension Name
(e.g. I,II, Jr., Sr., etc.)
Birthdate mm/dd/yyyy

Sex Choose from dropdown.

Employment Status Choose from dropdown.

Employment Type Choose from dropdown.

Highest education attained - Level
Choose from dropdown.
[e.g Bachelor’s, Master’s, Doctoral]
Program of Highest education
attained [e.g, BS in Computer
Science]

Discipline of Highest education

Choose from dropdown.
attained
Teaching Discipline for faculty OR
Designation for non-teaching Choose from dropdown.

Mailing address (fill out blank spaces below)

Blk No., Lot No.
Street Name
Barangay
City/Municipality
Province
Active E-mail Address
Alternate E-mail Address
Mobile Number
Alternate Mobile Number/Landline
SCHOLARSHIP BANK DETAILS
DBP Prepaid Account Number
(Indicate the old DBP card number)
DBP-CHED Savings Account Number
(Indicate the NEW DBP card number
with EMV chip, if applicable)

SCHOLARSHIP/ GRANT DETAILS

Scholarship Type Choose from dropdown.
Grant Status as of March 2018
Choose from dropdown.
(e.g. Active, LOA, Withdrawn)
SHEI Region Choose from dropdown.
Sending Higher Education Insitution
Choose from dropdown.
Name
Sending Higher Education Insitution
Unique Institutional Identifier #N/A
(automated, do not edit)
DHEI Region Choose from dropdown.
Delivering Higher Education Insitution
Choose from dropdown.
Name
Delivering Higher Education Insitution
Unique Institutional Identifier #N/A
(automated, do not edit)
Name of Program Enrolled
Choose from dropdown.
(Complete name of program)
Academic Year Started Choose from dropdown.
Term Started Choose from dropdown.
Academic Year of Completion Choose from dropdown.
Term of Completion Choose from dropdown.
STUDY PLAN
Please fill out the table below with your updated Study Plan as approved by your program adviser and/or dean and as what
Records.

Make sure to indicate all subjects taken whether passed, failed, INC, in progress, etc.

Please take note that all changes from the old study plan, especially retaken subject/s or subject/s to be retaken must be re
the subject was enrolled or will be enrolled.

**Merge documents in one file using this free online software MERGE PDF

Upload ORIGINAL Approved Study

Plan (signed by adviser and/or dean) (upload through chedk12.com/dbpmigrationoffline)
here for verification purpose:

Upload MODIFIED Approved Study

Plan (signed by adviser and/or dean)
(upload through chedk12.com/dbpmigrationoffline)
here for verification purpose:
(if applicable)

Academic Year Term Course Code Subjects

AY 2016 - 2017 Term 1

AY 2016 - 2017 Term 1

Academic Year Term Course Code Subjects

AY 2016 - 2017 Term 2

Academic Year Term Course Code Subjects

Term 3 /Non-
AY 2016 - 2017
Regular Term

Academic Year Term Course Code Subjects

Term 4/Non-Regular
AY 2016 - 2017
Term

Academic Year Term Course Code Subjects

AY 2017 - 2018 Term 1

Academic Year Term Course Code Subjects

AY 2017 - 2018 Term 2

Academic Year Term Course Code Subjects

Term 3 /Non-
AY 2017 - 2018
Regular Term

Academic Year Term Course Code Subjects

Term 4/Non-Regular
AY 2017 - 2018
Term

Academic Year Term Course Code Subjects

AY 2018 - 2019 Term 1

Academic Year Term Course Code Subjects

AY 2018 - 2019 Term 2

Academic Year Term Course Code Subjects

Term 3 /Non-
AY 2018 - 2019
Regular Term

Academic Year Term Course Code Subjects

 Term 4/Non-Regular
AY 2018 - 2019
Term

Academic Year Term Course Code Subjects

AY 2019 - 2020 Term 1

Academic Year Term Course Code Subjects

AY 2019 - 2020 Term 2

Academic Year Term Course Code Subjects

Term 3 /Non-
AY 2019 - 2020
Regular Term

Academic Year Term Course Code Subjects

Term 4/Non-Regular
AY 2019 - 2020
Term

Academic Year Term Course Code Subjects

AY 2020 - 2021 Term 1

AY 2020 - 2021 Term 1

Academic Year Term Course Code Subjects

AY 2020 - 2021 Term 2

Academic Year Term Course Code Subjects

Term 3 /Non-
AY 2020 - 2021
Regular Term

Academic Year Term Course Code Subjects

Term 4/Non-Regular
AY 2020 - 2021
Term

By submitting this form,

I certify that the information indicated are valid, authentic, true and correct based on my own personal knowledge and base
I give my consent to the collection and processing of my personal information for the purpose stated herein.
I agree that the Commission shall use the information for administrative purposes and for whatever purpose deemed essen
or engagement.
I acknowledge that the Commission will keep all information strictly confidential and shall not reveal to any person or entity o
expressly directed by government or required by law.
l (SGS-L) program and Sectoral Engagement (SE) program,
This is consistent with the mandate of the Bangko Sentral ng
p cards.

hip/Grant. To receive the certification, all active scholars and

tion to EMV-Compliant Savings Account and the maintenance of the
nt before June 2018.

ABCUniversity _ Juan Dela Cruz.xls

of the following:

12.com/dbpdepositslip.
nd/or dean and as what would appear on your Transcript of

o be retaken must be reflected on the corresponding term where

If Others, please
Units Remarks
specify:
 If Others, please
Units Remarks
specify:

If Others, please
Units Remarks
specify:

If Others, please
Units Remarks
specify:

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Units Remarks
specify:

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Units Remarks
specify:
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Units Remarks
specify:

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Units Remarks
specify:

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Units Remarks
specify:

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Units Remarks
specify:

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Units Remarks
specify:

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Units Remarks
specify:
 If Others, please
Units Remarks
specify:

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specify:

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Units Remarks
specify:

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specify:

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Units Remarks
specify:
 If Others, please
Units Remarks
specify:

If Others, please
Units Remarks
specify:

If Others, please
Units Remarks
specify:

nal knowledge and based on documents in my possession.

d herein.
purpose deemed essential for monitoring the progress of my study

to any person or entity or use any information at any time unless