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LIFELINE ASSISTANCE FOR NEIGHBORS

IN-NEED
SCHOLARSHIP CHECKLIST
Basic/SUC/LCU/Basic + SUC/LCU
Name:
____________________________________________
_______________
School:
____________________________________________
_______________
CHECKLIST OF REQUIREMENTS TO BE
SUBMITTED (2 sets)
_____ Filled-up Application Form with 2X2
Recent Picture
_____ Enrolment Form for the Current
Semester/Term with Official Receipt, if
applicable
_____ Authenticated or True Copy of Grades
last semester, with school seal/official
signature (for trimester, grades for the
past 2 terms)
_____ High School Card/Any proof of having
graduated from your stated High School
(for Freshmen/New Applicants)
_____ Certificate of Good Moral Character
(Issued within the year)
_____ School ID (back to back photocopy in a
single page)
_____ 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.)
_____ Voters Certification issued by
COMELEC issued after May 2013
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)
Instructions
1. Please submit your Scholarship
Application at the Senator Renato
"Compaero" Cayetano Memorial
Science and Technology High
School (SRCC or Cayetano Science),
Pamayanang Diego Silang, Brgy. Ususan,
Taguig City on the dates of acceptance
of application. Check the Scholarship
Secretariat (Taguig) FB Account and
www.taguig.gov.ph regularly for
announcements regarding dates and
venue.
2. Please come with 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.
3. Please fill up all the data
requirements in the Application
Form and submit all the
documentary requirements needed

during the Application Period.


Incompletely filled-up Scholarship
Application Forms or those with
incomplete requirements shall NOT be
accepted, or IF inadvertently accepted,
it shall NOT be processed.
LIFELINE ASSISTANCE FOR NEIGHBORS
IN-NEED
SCHOLARSHIP CHECKLIST
Basic/SUC/LCU/Basic + SUC/LCU
Name:
____________________________________________
_______________
School:
____________________________________________
_______________
CHECKLIST OF REQUIREMENTS TO BE
SUBMITTED (2 sets)
_____ Filled-up Application Form with 2X2
Recent Picture
_____ Enrolment Form for the Current
Semester/Term with Official Receipt, if
applicable
_____ Authenticated or True Copy of Grades
last semester, with school seal/official
signature (for trimester, grades for the
past 2 terms)
_____ High School Card/Any proof of having
graduated from your stated High School
(for Freshmen/New Applicants)
_____ Certificate of Good Moral Character
(Issued within the year)
_____ School ID (back to back photocopy in a
single page)
_____ 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.)
_____ Voters Certification issued by
COMELEC issued after May 2013
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)
Instructions
1. Please submit your Scholarship
Application at the Senator Renato
"Compaero" Cayetano Memorial
Science and Technology High
School (SRCC or Cayetano Science),
Pamayanang Diego Silang, Brgy. Ususan,
Taguig City on the dates of acceptance
of application. Check the Scholarship
Secretariat (Taguig) FB Account and
www.taguig.gov.ph regularly for
announcements regarding dates and
venue.
2. Please come with 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.
3. Please fill up all the data
requirements in the Application
Form and submit all the
documentary requirements needed

during the Application Period.


Incompletely filled-up Scholarship
Application Forms or those with
incomplete requirements shall NOT be
accepted, or IF inadvertently accepted,
it shall NOT be processed.

OFFICE OF THE MAYOR


Taguig City, Philippines

Recent
2x2
ID Picture

LIFELINE ASSISTANCE FOR NEIGHBORS IN-NEED


SCHOLARSHIP APPLICATION FORM
Basic/SUC/LCU/Basic + SUC/LCU
Instructions:
1. PRINT all entries.
2. Place an X in the appropriate blank provided.
Date:__________________________________

SCHOLARSHIP APPLIED FOR


_____ Basic Scholarship
_____ New Applicant
School Year: _________________
Number of semesters
_______________________

_____ SUC/LCU
_____ Renewing Applicant
Semester: _____ 1st Sem

that

you

have

benefitted

_____ Basic + SUC/LCU


_____
from

the

2nd

Sem

Scholarship:

PERSONAL INFORMATION
Name:
_________________________________________________________________________________________
_______________________
(Last Name)
(First Name)
(Middle
Name)
Address:
_________________________________________________________________________________________
____________________
Barangay: _________________________________________ Years of Residency in Taguig
(applicant): _________
Mobile/Landline Phone Numbers:_________________________________________________
Age: _________________
Place of Birth: ____________________________________
Date
of
Birth:___________________________________________
Gender: ____________
Marital Status: ____________
Religion:
________________________________________________
E-mail
Address:
______________________________________________________________________________
Residence: _____Owned by family _____Owned by relatives _____Renting ____Paying-toown
_____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 _____ No
Have you been accused or convicted of any offense/crime? ____ Yes
_____ No
If the answer to any of the last 2 questions above is Yes, please provide details:
_________________________________________________________________________________________
_______________________________
EDUCATIONAL BACKGROUND
Course:
_________________________________________________________________________________________
______________________
Year Level: _______ Graduating this semester? _____Yes _____No
Grade Ave. last
sem:_______________
Regular duration of Course: _____5 years _____4 years _____3 years _____2 years
_____Others
(specify)
____________________________________________________________

How many semesters more to go before you graduate, including the current sem/term?
_________________
School:__________________________________________________________________________________
______________________________
School
Address:
_________________________________________________________________________________________
____________

Name of Schools
Graduated From

High School:
Elementary:

School
Type
(Indicat
e if
Public
or
Private)

School Address
(Barangay and
City/Municipality)

Year
Started
Year
Graduat
ed

Honors/Award
s Received
(if any)

FAMILY BACKGROUND
FATHER
( ) Living ( )
Deceased

MOTHER
( ) Living ( )
Deceased

HUSBAND/WIFE
(If Married)

Name
Address
Contact No.
Occupation
Place of
Work
Highest
Educational
Attainment
Ave.
Monthly
Income
Number of siblings in the family (including applicant):___________________. Please fill out
information below about your siblings:
Age
Marit
Highest
If
working,
indicate
al
Educational
where they work &
Name
Statu
Attainment
their average monthly
s
(M
(as of date)
income
or S)

I hereby certify that ALL the answers given above are TRUE and CORRECT to
the best of my knowledge and that the attached documents are faithful reproduction of
the original copies. I further acknowledge that ANY ACT OF DISHONESTY OR
FALSIFICATION
MAY
SERVE
AS
A
GROUND
FOR
MY
PERPETUAL
DISQUALIFICATION from this Scholarship Program.
I also understand that this submission of application does NOT automatically
qualify me for the scholarship grant and that I will abide by the decision of the L.A.N.I.
Scholarship Management.
Thank you very much.
_____________________________________________________________________________
_______________________________
Printed Name & Signature of Applicant
Date
Attested by:
_____________________________________________________________________________
______________________________
Printed Name & Signature of Parent/Legal Guardian
Date

Rev.3.8.15

Investing in education, investing in the Citys Foundation!