The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program APPLICATION FORM (PERSONAL DATA)

Name Age Date of Birth Lastname, Firstname Middlename 18 Last Sex Male First Citizenship Filipino Place of Birth (Month/Day/Year) Permanent Home Addess No./Street Present Address Present Address No./Street City/Town Province Zip Code City/Town Province Zip Code Middle Religion Place Of Birth We want to know some basic information about you. Please print all information legibly. Nickname Nickname Religion

1/1/2011

Permanent Home Address

Contact Details
Family Father Mother

(000) 888-88-88 Landline No./s

Name Father's Name

(63) 888-888-88-88 Mobile No./s

Age 00 00 Highest Educational Attainment Elementary Elementary Elementary

email_add@emailadd.com Email Ad./s

Present Occupation (Indicate Present Company Name, Address and Tel. Nos.) Present Occupation Present Occupation Present Occupation

Mother's Name Guardian/s (if parents are not living) Guardian's Name 00

Siblings

Sibling's Name Sibling's Name Sibling's Name

00 00 00

Elementary Elementary Elementary

Present Occupation Present Occupation Present Occupation

Note: You may use another sheet to list down your other siblings information.
Form 1.5.1: Application Form 1

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program ACADEMIC INFORMATION
Current Course and Year Level Name of University/College Address Student Affairs Head President/Dean Address of University Student Affairs Contact Details: Head Landline, Fax, Email Address, Mobile No. President / Dean Contact Details: Landline, Fax, Email Address, Mobile No. High School Address of High School Contact details Contact details Course and Year Level University Expected year of Graduation 2000

Name of High School Where Graduated From Address

Year Graduated from HS

2000

Have you ever been subject to academic or disciplinary action from any school or institution attended? If yes, kindly explain briefly. Disciplinary record Other Contact Details (Blog, Personal Website, Facebook, Multiply, Twitter, Plurk, Friendster, Etc.) Other contact details How did you learn about the NCA Leadership Journey? (Please check all applicable.) Office of Student Affairs/Activities iamninoy-iamcory Website Blogs, Social Networking Sites Email Announcements Through Relatives, Friends, Orgmates, Etc. Personal Invitation from the Foundation Traditional Media (TV, Radio, Newspapers) Others (please specify) ____________ I certify that all data and information in this application form are true and correct. _____________________________ Signature over Printed Name of Applicant _________3/15/2011_______ Date

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program
Form 1.5.2: Application Form 2

LIST OF STUDENT/YOUTH LEADERSHIP EXPERIENCE

We want to know the depth and breadth of your student-leadership experience. List all of your school or community-based leadership positions from freshman college year to present. Kindly list them by the most present leading up to the freshman year. Spell out acronyms of your organizations. No. Ex. Ex. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Position/Designation President Internals Vice President Position / Designation Position / Designation Position / Designation Position / Designation Position / Designation Position / Designation Position / Designation Position / Designation Position / Designation Position / Designation Position / Designation Position / Designation Position / Designation Position / Designation Position / Designation Name of Organization Student-Government Peer Counseling Group Organization Organization Organization Organization Organization Organization Organization Organization Organization Organization Organization Organization Organization Organization Organization School Year/Year 2009-2010 2008-2009 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001

Note: You may use another sheet to list down your student leadership experience.

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program
Form 1.5.3: Application Form 3

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program LIST OF COMMUNITY INVOLVEMENT/PUBLIC SERVICE ACTIVITIES
We want to know the depth and breadth of your public service work. List all of your community-based projects, programs, and activities. Kindly list them by the most present leading up to the freshman year. Spell out acronyms of the communities and organizations. No. Ex. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Name of Community Purok 12, Brgy. 17, Davao City Community Community Community Community Community Community Community Community Community Community Nature of Work o Feeding Program for the Malnourished Children o Tutoring to Grade School Children Work Work Work Work Work Work Work Work Work Work School Year/Year 2009-2010 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001

Note: You may use another sheet to list down your community involvement.

Form 1.5.4: Application Form 4

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program LIST OF AWARDS
We want to know the recognition and validation you have received already. List all of your awards received from school, other organizations, etc. Kindly list them according to chronological order starting from the recent awards. Spell out acronyms of the organizations. No. Ex. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Award Name Most Outstanding Individual Award Award Award Award Award Award Award Award Award Award Name of Organization Pinaglabanan School of Nursing Organization Organization Organization Organization Organization Organization Organization Organization Organization Organization School Year/Year 2010 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001 2000-2001

Note: You may use another sheet to list down your awards.

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program
Form 1.5.5: Application Form 5

LIST OF SEMINARS ATTENDED

We want to know the conferences, seminars and prestigious gatherings that you have attended and the places that you have been to. List all of your seminars that you have attended including the ones you have submitted to for this year. Kindly list them according to chronological order, starting from the recent seminars. Spell out acronyms of the organizations. No. Ex. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Seminar/Conference Name and Venue World Leadership Conference, Manila Seminar Name Seminar Name Seminar Name Seminar Name Seminar Name Seminar Name Seminar Name Seminar Name Seminar Name Seminar Name Name of Organizers World Leadership Center, Inc. Organizer Organizer Organizer Organizer Organizer Organizer Organizer Organizer Organizer Organizer Date January 4-6, 2011 Duration Duration Duration Duration Duration Duration Duration Duration Duration Duration

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program
Form 1.5.6: Application Form 6

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program ESSAY
We want to get to know you more. Kindly follow the instructions thoroughly and honestly. The essay should have a maximum of 1,000 words only. Question: What has been the biggest problem or challenge that you have experienced in the past 5 years? Narrate the situation and share how you overcame it. You can write your essay in English or Filipino. Type text here

Form 1.5.7: Application Form 7

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program
Type text here

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program VIDEOESSAY
We want to get to know you more. For 3-5 minutes, talk about yourself and why you want to be part of the NCA Leadership Journey while shooting yourself using a video camera or a webcam. You can answer this part in English or Filipino. Kindly save your video-essay (mp4, flv, wma, mpeg file format). Store it in a blank CD.

Form 1.5.8: Application Form 8

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program MENTOR/ADVISER 1 RECOMMENDATION FORM
Your student/mentee has chosen you to recommend him/her to the NCA Leadership Journey. To help the organizers assess the applicant better, kindly answer the questions below. Seal the recommendation form in a white envelope and sign on the seal. Give this to your student/mentee as part of his application to the program. Name of Mentor/Adviser Department/ Organization/ University How long have you known the applicant? Mentor's Name Department / Organization / University Contact Numbers/ Address Email Address Contact details

e-mail Address

duration

Please rate the applicant using the qualities below using the scale provided. EX Excellent MS Meets Standards VG Very Good NI Needs Improvement

Sense of self Sense of responsibility Goal-orientation Ability to lead

EX EX EX EX

Ability to work with peers Resilience and flexibility Creativity and strategy Conceptual thinking

EX EX EX EX

Emotional maturity Spiritual maturity Sense of service Communication skills

EX EX EX EX

Use the space below for your qualitative evaluation of the applicants leadership and impact to his/her community. Cite specific examples of positive influence that the applicant has brought and areas for improvement.

Type text here

__________________________________ Signature over Printed Name of Mentor/Adviser

Form 1.6.1: Recommendation Form 1

_________3/15/2011_______ Date

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program MENTOR/ADVISER 2 RECOMMENDATION FORM
Your student/mentee has chosen you to recommend him/her to the NCA Leadership Journey. To help the organizers assess the applicant better, kindly answer the questions below. Seal the recommendation form in a white envelope and sign on the seal. Give this to your student/mentee as part of his application to the program. Name of Mentor/Adviser Department/ Organization/ University How long have you known the applicant? Mentor's Name Department / Organization / University duration Contact Numbers/ Address Email Address Contact details

e-mail Address

Please rate the applicant using the qualities below using the scale provided. EX Excellent MS Meets Standards VG Very Good NI Needs Improvement

Sense of self Sense of responsibility Goal-orientation Ability to lead

EX EX EX EX

Ability to work with peers Resilience and flexibility Creativity and strategy Conceptual thinking

EX EX EX EX

Emotional maturity Spiritual maturity Sense of service Communication skills

EX EX EX EX

Use the space below for your qualitative evaluation of the applicants leadership and impact to his/her community. Cite specific examples of positive influence that the applicant has brought and areas for improvement.

Type text here

__________________________________ Signature over Printed Name of Mentor/Adviser

Form 1.6.2: Recommendation Form 2

_________3/15/2011_______ Date

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program APPLICATION PROCESS
Thank you for completing the requirements of your application. It signifies your intent to join our program and we are grateful for that. Below is a brief of the application process for you to understand and set the proper expectations. Round 1 Round 2 Round 3 Completion of Requirements Reading of Application Forms Personal/Live Interview (for NCR/Greater Manila Area-Based) Or Online Interview via Skype, Oovoo, Yahoo, etc. (for non-NCR/GMA-based) Final Deliberations

We will be informing the applicants of their status via email as we move on with the application process.

The NCA Leadership Journey

NCACL/iamninoy-iamcory Youth Formation Program
Form 1.7: Application Process