OFFICE OF THE MAYOR Recent

Taguig City, Philippines 2x2

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

Honors (Top of the batch) Priority__________________________SUC/LCU

Premier Basic Scholarship ____ Basic Plus

Applying for Merit Incentive? Yes No Weighted Ave. last sem:

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.

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:

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.

Date:
Printed Name & Signature of Applicant

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

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