Scholarship Form
Scholarship Form
1.
Surname
Given Name
Course
Middle Name
2.
3. General Weighted Average
(Not lower than 2.50)
Submit certified true copy of previous trimester (no failing grades)
4. Membership and participation in Extra-Curricular activities, school and/or community
Inclusive dates
Position held
Name of organization
Salary/Month P
Salary/Month P
6.2. Certification from the Guidance Office and Office of the Student Affairs that
he/she has not been subjected for any disciplinary action.
6.2.
Signature of Applicant
Date
AFFIDAVIT OF UNDERTAKING
STUDENT SCHOLARS
That
am
awarded
scholarship
grant/financial
assistance
2.
________________________________________________________.
That said scholarship/grant/financial assistance is effective for a period of
on
________________________ beginning_____________________________________
3.
4.
_____________________________________________________________________.
That the entire costs of the scholarship/grant/financial assistance to be shouldered by
5.
6.
7.
AFFIANT
Doc. No.____________
Page No.____________
Book No.____________
Series of_____________