OFFICE OF THE MAYOR

Taguig City, Philippines

L.A.N.I. SCHOLARSHIP APPLICATION FORM

Recent
2x2
ID Picture

Basic/Basic + SUC/LCU/SUC/LCU
Second Semester SY 2014 -2015

Instruction:
1. PRINT all entries
2. Place an X in the appropriate blank provided
Date:_____________________________

SCHOLARSHIP APPLIED FOR

____ Basic Scholarship
__x__ Basic Plus SUC/LCU
____
SUC/LCU
______ New Applicant
___x____ Renewing Scholarship (Renewal for
______________________ Time)
Graduating this semester/term _x__ Yes _____ No
If yes, are you graduating with honors?
______Yes ___x___ No
If no, how many semesters more to go before you graduate, including the current sem/term?
_________________
Regular duration of Course: _____ 5 years
___x__ 4 years
_____ 2 years_____Others
(pls.
specify) ______________
Please provide 2 (two) sets of all the documents.
All photocopied documents to be
submitted should be faithful reproduction of the original. Bring the original copies of
documents for validation purposes. Ask for the Receiving Copy upon submission.

REQUIREMENTS TO BE SUBMITTED
_____ Filled-up Application with 2X2 Recent Picture
_____ Enrolment Form for the Current Semester/Term
with Official Receipt
_____ Certificate of Good Moral Character (Issued
within
the school year
_____ School ID back to back (photocopy)
_____ Other necessary documents to facilitate the
processing
of your scholarship application (Transcript or
True Copy
of Grades since start of college for New
Applicants who
are continuing students, Scholarship Voucher,
EVS Certification, F137, Course Curriculum,
Birth Certificate, etc.)

_____ Authenticated Copy of Grades last sem, with

school seal
(for trimester, grades for the past 2 terms)
_____ High School Card/Any proof of having
graduated form
from your stated High School for
Freshmen/New
Applicants
_____ Voters Certification issued by COMELEC
showing that
at least one of the parents of the applicant is
a
registered voter
_____ Voters Certification of the applicant (for 18
years old
and above)

PERSONAL INFORMATION
Full
Name:
_________Alcantara___________________________Julius
Eric________________________________Tesorero_______
(Last Name)
(First Name)
(Middle
Name)
Address:
_________B25
L27__Sonalan
St.
Upper
Bicutan
Taguig
City_______________________________________________
Barangay: _________Upper Bicutan_________________ E-mail
Address:
______juliuseric_28@yahoo.com_____________
Mobile Phone No.:____09201077560__________
Telephone No.: ___839-43-46_________
Age: ______19_________
Date of Birth:_______July 29, 1995_______________ Place of Birth: _____Taguig City_______________
Gender: ___Male____
Years of Residency in Taguig (applicant): ____19__ Marital Status:
____Single____
Religion:
____Catholic______
Residence: ______Owned by family_____ Owned by relatives __x__ 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 __x_ No . Have you been
accused or convicted of any offense/crime? ____ Yes
__x__ No If the answer to any of the
last 2 questions above is Yes, please provide details:

__________________________________________________________________________________________________
____
COURSE and SCHOOL
Course: ______Bachelor of Science in Office Administration_______Year Level: ___4th____
Ave. last sem:____1.75____
School:___Polytechnic
University
of
Philippines________________________________________________________________________
School
Address:
_____General
Santos
Ave,
Taguig,
Manila_______________________________________________________

Name of Schools
Attended
High School: Dr. Arcadio
Santos
National
High
School
Elementary:
Moreh
Academy

Name
Address
Contact No.
Occupation
Place of
Work

EDUCATIONAL BACKGROUND
School
Type
(Indicate if
School Address
Public or
Private)

Public

Km.15
Road.

Privat
e

Bonifacio
City

East
Ave.

Year
Started
Year
Graduat
ed

the
Metro

Honors/Award
s Received
(if any)

Serivce 2011
Taguig 2007

FAMILY BACKGROUND
FATHER
MOTHER
(x ) Living ( )
(x ) Living ( )
Deceased
Deceased
Neptali Alcantara
Nancy Alcantara
B- 25 L- 27 Sonalan St.
B- 25 L- 27__Sonalan St.
Upper Bicutan Taguig City Upper Bicutan Taguig City
839-43-46
839-43-46
Salesman
none
n/a
n/a

Highest
Educational
Attainment
Ave. Monthly
Income

Grade

College

College

10,000

n/a

HUSBAND/WIFE
(If Married)

Number of siblings in the family (including applicant):_______. Please fill out information below
about your siblings:
Ag Marita
Highest
If working, indicate where
e
l
Educational
they
work
&
their
Name
Status
Attainment
average monthly income
(M or S)
(as of date)
18
S
College
Johna Alcantara
Joseph Alcantara
16
S
College
Jarmaine Alcantara

15

High School

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 PERPETUAL DISQUALIFICATION from this scholarship program. Thank you
very much.

_____________________________________________
________________
Printed Name & Signature of
Applicant
Date:
____________________________________________________
Attested by: __________________________________________________________________
___________________________
Printed Name & Signature of Parent/Legal Guardian

Date:

Definition:
Basic Plus
SUC/LCU
SUC/LCU
Basic

Graduate of public high school in Taguig or nearby LGUs, who is enrolled or enrolling in
an SUC or LCU in the NCR.
Graduate of private school who is enrolled or enrolling in an SUC or LCU in the NCR.
Graduate of any public high school in Taguig or nearby municipalities or cities within the
NCR who is enrolled in other schools apart from SUC or LUC in the NCR.

Announcement:
Acceptance of Applications for third batch, SECOND SEMESTER SY 2014-2015:
Third & Last Batch (to include PUP-T and LEAD applicants): February 16 27, 2015, 9:00 AM
3:00 PM,
Mon-Fri (except holidays)
Venue: Senator Renato "Compaero" Cayetano Memorial Science and Technology High
School (SRCC or Cayetano Science) Auditorium, Pamayanang Diego Silang, Brgy. Ususan,
Taguig City

Rev.1.7.15

Investing in education, investing in the Citys Foundation!