REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF LABOR AND

EMPLOYMENT DEPARTMENT OF
EDUCATION CENTRAL OFFICE
SPECIAL PROGRAM FOR THE EMPLOYMENT OF
STUDENTS 2014
APPLICATION
FORM
SURNAME FIRST MIDDLE NAME GENDER CIVIL
STATUS DATE OF BIRTH M D Y AGE PLACE OF
BIRTH
ADDRESS
CITIZENSHIP CONTACT NUMBER
NAME OF FATHER OCCUPATIO
N
NAME OF MOTHER OCCUPATIO
N
EDUCATION NAME OF SCHOOL DEGRE
E
NO. OF
UNITS
COMPLETE
INCLUSIV
E
DATE
OF
SECONDARY
TERTIARY
VOCATIONAL
DOCUMENTS CHECKLIST:
(Original copy, if applicable, or authenticated / certified true copy documents should be presented for validation)
Duly accomplished SPES Application Form
Birth Certificate or any document that could show the applicants birth date. (NSO/ertified !rue opy)
Income ta returns of both parents. If non!filers of I"#$ they must brin% an affida&it duly certified by the
BI# that
the annual net income of both parents does not eceed Php. '()$***. ollege Student+ #ecent %rades and school re%istration preferably in the second semester , Form ')-.
Out"of"School Youth+ .rades before droppin% out of school , Certificate of Indi%ence from the Baran%ay
where the
/S0 resides.
SPECIAL SKILLS:
I hereby attest that the information abo&e are true and correct to the best of my 1nowled%e$ includin% the attached
documents or re2uirements which I also attest as to their &eracity. I a%ree that any false statement would cause the
automatic dis2ualification or cancellation of the ser&ice or %rant and I shall refund the amount recei&ed and,or pay
dama%es to the Department of 3abor and Employment or comply with other sanctions in accordance with law.
Any material chance in my
financial status may affect my eli%ibility to continue the
pro%ram.
Signature of #pplicant over $rinted
Name