CHED FACULTY DEVELOPMENT PROGRAM II

Name of Applicant Scholar: ___________________________________ Home / Sending HEI: _______________________________________ Program applied for: _________________________________________

(Write your name at the back of the picture)

Picture of Applicant

Documents Submitted:

Document / s For the CHED Scholarship Application 1. Scholarship application form List of courses offered by SHEI* Total College/University Enrollment Certification from School Head Teaching Load

Complied

Not Complied

Date Complied

2. 3. 4. 5.

Certification that grantee has no pending administrative charges Certification that grantee has no pending scholarship program being undertaken Certification of employment indicating Official Designation, Status of Employment (Full/Part-Time), Tenure (Permanent, Probationary, Contractual or Temporary) and Date hired. Recommendation Transcript of Records (for every course taken: BA/BS, MA/MS, units earned) Rehiring Agreement (if not permanent in SHEI) Medical Certificate Doctors Certificate (to be administered by a Government physician) Urinalysis Fecalysis Complete Blood Count X-ray result

6. 7. 8. 9 10. 11.

NBI or Police Clearance Birth Certificate (Issued by NSO) SHEI Institutional Faculty Plan Signed Scholarship Contract (5 copies) Co-maker Undertaking (5 copies) Income Tax Return of Co-maker

CHED FACULTY DEVELOPMENT PROGRAM II

After CHED Approval

12.

Photocopy of any valid ID/Passport of all the contract signatories

*SHEI Sending Higher Education Institution