OSFA-F3-2008

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

OFFICE OF SCHOLARSHIP & FINANCIAL ASSISTANCE
Sta. Mesa, Manila

APPLIPCATION FORM FOR SCHOLARSHIP/FINANCIAL

ASSISTANCE/SPECIAL GRANT

______________________________
Date
The Vice President for Student Services
PUP, Sta. Mesa, Manila

Thru: The Chief, Office of Scholarship & Financial Assistance

Dear Sir/Madam:

I have the honor to apply for scholarship/grant/financial assistance.

A. SCHOLARSHIP
1. ENTRANCE

Valedictorian
Salutatorian
First Honorable Mention

Achiever/Awardee

Campus Journalist

Outstanding Artist

Outstanding Athlete

President of High School Student Council
2. ACADEMIC

Presidents List
Deans List
B. FINANCIAL ASSISTANCE
1. SERVICE GRANT

University Central Student Council Officers

President
Vice President
Secretary

Treasurer
Others (Specify) _______________________

University Student Publication Staff Members

Editor-in-chief
Managing editor
Associate Editor

Photo Journalist
Cartoonist
Sports Editor

Others (Specify) _________________

University Athlete

University Cultural Group Member

Banda Kawayan
Sining Lahi Polyrepertory

Brass Band
Polysound
Guhit Sudulungan

Lente Photoclub
Ramp Artist
Rondalla

LHS Choral Group
LHS Lyre Drum

Bagong Himig/Serenata
Sining Lahi Polyrepertory

Maharlika Dance Artists/Contemporary Dimensions

Others (Specify) ____________________

ROTC Officer

Film Center Creative Artist
2. STUDENT ASSISTANTSHIP
C. SPECIAL GRANT
Name of Grant: _____________________________________________________

Should my application be approved, I Promise to abide by the rules, regulations and

guidelines promulgated by the Scholarship Committee, as well as that of the
University, and to be a scholar worthy of the name of the University.

Respectfully yours,

_______________________________
Signature over printed name
Course/Year/Section ______________