OFFICE OF THE MAYOR

Taguig City, Philippines

Recent
2x2
LIFELINE ASSISTANCE FOR NEIGHBORS’ IN-NEED ID Picture
SCHOLARSHIP APPLICATION FORM (taken in the
For RENEWING Applicants
last 6 months)
Instruction:
1. PRINT all entries. Place an Xon the appropriate blanks.
2. Be HONEST and ACCURATE with your answers.
3. Arrange your requirements in 3 SETS (A,B&C). Date:_____________________________

SCHOLARSHIP APPLIED FOR

____ Honors (Top ______ of the batch) ____ Priority ____ SUC/LCU
____ Premier ____ Basic Scholarship ____ Basic Plus

No. of Semesters that you have benefited from the Scholarship _____________
CHECKLIST OF REQUIREMENTS TO BE SUBMITTED:

_____ Filled-up Application Form with 2X2 Recent Picture
_____ Enrolment Form for 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)
_____ Certificate of Good Moral Character
(Issued within the school year)
_____ School ID (back to back photocopy in a single page)
_____ Voter’s Certification issued by COMELEC,
showing that at least one of the parents of the applicant is a
registered voter (Issued after the May 13,2019 election)
_____ Voter's Certification of the applicant if 18 years old and above
(Issued after the May 13,2019 election)
_____ Birth Certificate
_____ 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, F137, Course Curriculum, PDAO Endorsement and
ID(for PWD Scholar), etc.

PERSONAL INFORMATION

Full Name: ________________________________________________________________________________________________________________________

(Last Name) (First Name) (Middle Name)
Address: ________________________________________________________________________Barangay: ______________________________________________
District (1 or 2):_________ Year when you started residing in Taguig ___________ Age: ___________ Gender: ______________________
E-mail Address: _______________________________________ Contact No.: ___________________________ Religion: ____________________________
Date of Birth:______________________________Place of Birth: ______________________________________ Civil Status(S/M): ___________________
COURSE and SCHOOL

Course: ___________________________________________________________________Ladderized? ____Yes ____ No GWA last sem:______________

Year Level: _________ No. of units enrolled: ___________Course Duration: _____ months_____ 2 yrs_____3 yrs _____4 yrs _____5yrs
Name of School:______________________________________________________________________________________________________________________
School Address: __________________________________________________________________________________________________________________________
Graduating this semester/term? ________ Yes _______ No If yes, are you graduating with honors? ______Yes _______ No
If no, how many semesters more to go before you graduate, including the current sem/term? __________________________ Others:
____ Octoberian ____Regular student ____Irregular student Transferee ____________________ Shiftee ___________________
(Previous school) (Previous course)
I hereby certify that ALL the answers given above are TRUE and CORRECT to the best of my knowledge, and the attached
documents are FAITHFUL REPRODUCTION of the original copies.I further acknowledge that ANY ACT OF DISHONESTY OR
FALSIFICATION MAY BE A GROUND FOR MY 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 so much.

_________________________________________________________________
Printed Name & Signature of Applicant Date: __________________________________________

Attested by:
__________________________________________________________________ Date: __________________________________________
Printed Name & Signature of Parent/Legal Guardian

Investing in education, investing in the City’s Foundation!