OFFICE OF THE MAYOR Recent

Taguig City, Philippines 2x2

ID Picture
LIFELINE ASSISTANCE FOR NEIGHBORS’ IN-NEED
SCHOLARSHIP APPLICATION FORM (taken in the
For RENEWING Applicants last 6 months)
Instruction:
1. PRINT all entries. Place an X on the appropriate blanks.
2. Be HONEST and ACCURATE with your answers.
3. Arrange your requirement in 3 SETS (A, B & C). Date:_____________________________
SCHOLARSHIP APPLIED FOR

____ Honors (Top ______ of the batch) ____ Priority ____ SUC/LCU
____ Premier ____ Basic Scholarship ____ Basic Plus

Applying for Merit Incentive? Yes No Weighted Ave. last sem:

No. of Semesters that you have benefited from the Scholarship _____________
CHECKLIST OF REQUIREMENTS TO BE SUBMITTED:
_____ Voter’s Certification issued by COMELEC,
_____ Filled-up Application Form with 2X2 Recent Picture showing that at least one of the parents of the applicant is a
_____ Enrolment Form for Current Semester/Term with registered voter (Issued after the May 13,2019 election)
Official Receipt, if applicable _____ Voter's Certification of the applicant if 18 years old and above
_____ Authenticated or True Copy of Grades last semester, (Issued after the May 13,2019 election)
with school seal/official signature (for trimester, grades _____ Birth Certificate
for the past 2 terms) _____ Other necessary documents to facilitate the processing of your
_____ Certificate of Good Moral Character scholarship application(Transcript or True Copy of Grades
(Issued within the school year) since start of college for New Applicants who are continuing
_____ School ID (back to back photocopy in a single page) students, F137, Course Curriculum, PDAO Endorsement
and ID(for PWD Scholar), etc.

Full Name: ________________________________________________________________________________________________________________________

(Last Name) (First Name) (Middle Name)
Address: ________________________________________________________________________Barangay:_______________________________________ _______
District (1 or 2):_________ Year when you started residing in Taguig ___________ Age: ___________ Gender: _____________________
E-mail Address: _______________________________________ Contact No.: ___________________________ Religion:
Date of Birth:______________________________Place of Birth: ______________________________________ Civil Status(S/M): ___________________

COURSE and SCHOOL

Course: ___________________________________________________________________Ladderized? ____Yes ____ No GWA:

Year Level: _________ No. of units enrolled: ___________Course Duration: _____ months_____ 2 yrs_____3 yrs _____4 yrs _____5yrs
Name of 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? __________________________
Others: ____ Octoberian ____Regular student ____Irregular student Transferee ____________________ Shiftee ___________________
(Previous school) (Previous course)

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.

Date:
Printed Name & Signature of Applicant

Attested by:

Date:
Printed Name & Signature of Parent/Legal Guardian

Investing in education, investing in the City’s Foundation!