12th NATIONAL YOUTH PARLIAMENT

21-25 October 2018

Davao City
APPLICATION FORM
Province:
Print legibly. Shade appropriate “Ο”.

I. PERSONAL INFORMATION

Name: _______________________________________________________________________________ Recent Passport Size

Family Name Given Name Middle Name Picture with white
background
Ο Male
Date of Birth: dd/mm/yyyy Age: Sex:
Ο Female
Permanent Address:

Residential Address:

E-mail Address:
Contact
Details: Mobile Number: CATEGORY OF DELEGATES
(Required) (Please shade all
Facebook Account URL: applicable)
Ο In- School Youth
Food Restrictions:
Ο Out-of-School Youth
Ο Working Youth
II. EDUCATIONAL BACKGROUND
Ο Specific Youth Groups /
Highest Youth with Special Needs*
Name of School / University /
Inclusive Dates Education Ο Sangguniang
College
Attainment Kabataan
Junior High School:

Senior High School:

College:

Vocational:

Post-Graduate:

III. CURRENT ORGANIZATIONAL MEMBERSHIP (Please attach additional sheet if necessary)

Organization** Inclusive Dates Position Held

**If a member or officials of the Sangguniang Kabataan, please indicate position and barangay name.

IV. YOUTH/COMMUNITY PROGRAMS ATTENDED

(Please attach additional sheet if necessary)

Inclusive Dates Description


youth with disabilities, youth with indigenous background, youth of OFWs, transnational youth, youth coming from LGBTQ
groups, victims of any kind of abused, neglected, trafficking, and addiction
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V. NYC PROGRAMS OR PROJECTS ATTENDED
Have you been involved in any NYC programs or activities? Ο Yes Ο No
If yes, please provide the details below. Please attach additional sheet if necessary.
Inclusive Date /
Name of NYC Program or Activity Involvement/Role
No. of Hours

Have you joined or attended any previous National Youth Parliament? Ο Yes Ο No

VI. MORAL CHARACTER REFERENCES

NAME DESIGNATION CONTACT NUMBER

VII. COMMITTEE MEMBERSHIP

Please rank from 1 to 9 according to your priority PYDP centers of participation, where 1 is the highest priority
Health Governance
Education Active Citizenship
Economic Empowerment Peace Building and Security
Social Inclusion and Equity Environment
Global Mobility
Note: Committee is based on your ranking and availability of slots per Center

PARENTAL/GUARDIAN’S CONSENT
(for applicants below 18 years old)

I, ________________________________, mother, father, legal guardian of

Ms./Mr.________________________________ do hereby understand and that I have read the information
provided above and decided to allow my child to participate.

____________________________
Signature over printed name

CERTIFICATION

I hereby certify upon my honor that all facts and information indicated herein are true and correct to the
best of my knowledge. I further declare that any information given by me that is untrue may constitute a
ground for expulsion in the 12th National Youth Parliament and prosecution for perjury.

Further, I subscribe and agree that the National Youth Commission has the sole prerogative to select,
reclassify and nominate the delegates to the 12th NYP, and its decision is final and executory.

I hereby commit myself to be available from October 21-25, 2018, and to actively participate in the post-
parliament activities for the next 2 years.

I expressly authorize the National Youth Commission or its representatives to use, share and process personal
information that I have provided, shared or declared in this form/document/site for any lawful purpose.

I am willing to shoulder my transportation/travelling expenses necessary to facilitate my participation to the

activity.

IN WITNESS hereof, I am executing and signing this statement voluntarily without compulsion.

__________________________________ ___________________________________
Date accomplished Signature of applicant

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 12th NATIONAL YOUTH PARLIAMENT
21-25 October 2018
Davao City
Name

Region
List down the
committee of
your choice
Identify the committies/issues and concerns; Identify the government interventions (laws, policies
and programs) to address the issues and concerns; Identify the gaps/shortcomings of the laws,
policies and programs implemented by the government? What are your recommendations?

Important: Limit your answer to 150-300 words.

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 REMINDERS

QUALIFICATIONS OF APPLICANTS APPLICATION REQUIREMENTS

1. Must be a Filipino Citizen 1. Accomplished 12th NYP Application Form
2. Must be 15-30 years old on the day of the 2. Essay: 150 to 300 words
Parliament 3. Copy of any Proof of Residence and Age (Any
3. Of good moral character valid IDs or document that indicates address
4. Able to read and write and date of birth):
5. Has not been convicted of any crime involving a. School ID or Company ID
moral turpitude b. Any Government Issued IDs: Postal ID,
6. Must not have been a previous National Youth GSIS, PhilHealth, Pag-Ibig, TIN, etc.
Parliament delegate c. Passport
d. Birth Certificate
4. Must be willing to shoulder his/her travelling
expenses
APPLICATION PROCESS

1. Applications for the 12th NYP may be hand-carried, mailed or emailed to the National Youth Commission.
2. The deadline for submission of complete documents is on July 27, 2018 (Friday) at 5:00 PM.
3. For hand-carried or mailed applications, they may be submitted not later than the set deadline to any of
the following NYC Offices:

12th NYP Screening and Selection Committee
National Youth Commission Central Office
3F West Insula Bldg., West Avenue corner EDSA,
Quezon City
National Youth Commission Naga
Ground Floor, Naga City Youth Center Bldg, Taal
corner Magsaysay Ave, Naga City
National Youth Commission Iloilo
Ground Floor, ME Bldg, Dungon B. Jaro, Iloilo City
National Youth Commission Davao
Door 1, Fuentes Bldg Quirino Ave., Davao City
National Youth Commission Baguio
Room 3 Lindi Hotel #12 Legarda Road,
Baguio City
National Youth Commission Cebu
5/F BF Building, N. Escario St. Cebu City
National Youth Commission Cagayan de Oro
2/F, Cebu CFI Community Cooperative Bldg,
Tiano Bros. cor. Mabini Sts.,
Cagayan De Oro City
National Youth Commission Zamboanga
3/F VHW Bldg (Landbank) Veterans Ave.,
Zamboanga City

4. For submission through mail, the NYP Secretariat/Cluster/Area Offices should receive the requirements
post marked on or before the set deadline.
5. Application documents, together with the scanned requirements may be submitted online to
nyp12@nyc.gov.ph on or before the set deadline.

E-mails must contain the following Subject format:

[Region, Province/Highly Urbanized City – Last Name, First Name Middle Initial]
Example: Region I, Ilocos Norte – Dela Cruz, Juan A

Applicants with incomplete requirements by 5:00 pm on the set deadline shall automatically be disqualified.

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