The 2021

BESPREN KABATAAN AWARDS

Search for Outstanding Kabataang Santiagueño, Youth Organizations
and Most Outstanding Sangguniang Kabataan

I. NOMINATION FORM

THE 2021 BESPREN KABATAAN AWARDS

The Secretariat
Local Youth Development Office,
Ground Floor, Santiago City Hall, San Andres, Santiago City 3311
lydosantiago@gmail.com

Ma’am/Sir:

After reviewing the search rules and procedures, it is our pleasure to

nominate:

Name of Nominee JEMERSON L. EUGENIO

Course MASTER OF ARTS IN EDUCATION MAJOR IN ENGLISH
ISABELA STATE UNIVERSITY-CENTRAL GRADUATE
School
SCHOOL
Address ECHAGUE, ISABELA

to the 2021 BESPREN KABATAAN AWARDS, Search for OUTSTANDING

KABATAANG SANTIAGUEÑO. We hereby certify that, to the best of our
knowledge, the information contained in this nomination form and the
accompanying supporting documents are true and correct.

We hereby agree to send our nominee, if selected, to the venue of the

panel interview by the Board of Judges and to attend the Awarding
Ceremonies. We understand that the decision of the Board of Judges is
final and binding.

Name of
Bethlyzelle Aniceto
Nominator
Address Salaysay, Dubinan West, Santiago City, Isabela
Telephone
n/a
Number
Mobile Number 09772790824
Email Address bhaby_lyzel@yahoo.com

BETHLYZELLE ANICETO
Signature over printed name of nominator/date
 The 2021
BESPREN KABATAAN AWARDS
Search for Outstanding Kabataang Santiagueño, Youth Organizations
and Most Outstanding Sangguniang Kabataan

II. NOMINEE’S PERSONAL DATA

EUGENIO JEMERSON LOPEZ JEM

_________________________________________________________________________________________ ___
Last Name First Name Middle Name Nickname
BLOCK 33, LOT 7, BALDWIN STREET, GREENLAND HOMES SUBDIVISION, PLARIDEL, SANTIAGO CITY, ISABELA
_________________________________________________________________________________________ ___
Home Address
09558423236 jemersoneugenio1998@gmail.com
_________________________________________________________________________________________ ___
Mobile Number E-mail Address
OCTOBER 9, 1998 22 SINGLE
_________________________________________________________________________________________ ___
Date of Birth Age Civil Status
FILIPINO MALE
_________________________________________________________________________________________ ___
Citizenship Gender

Family Background

Age Profession/Occupation
Father: WILMER G. EUGENIO - DECEASED
Mother: JENNIFER L. EUGENIO 40 RESTAURANT OWNER
Sibling/s: JASMIN L. EUGENIO 21 STUDENT
JHAREND L. EUGENIO 12 STUDENT

III. NOMINEE’S EDUCATIONAL PROFILE

Citation/Awards
Name of School Year Graduated
received
Elementary Dubinan Elementary School 2010 2nd Honorable
Mention
High School Sisters of Mary Schools-Adlas, 2015 3rd Honors
Inc.
College University of La Salette, Inc. 2019 Cum Laude
Other school (if Sisters of Mary Technical 2015 BPP NC II Holder
any) Education Institute

IV. NOMINEE’S HOBBIES AND INTERESTS

1. Writing poems and column articles
2. Watching TED Talks and Documentaries
3. Watching movies
4. Reading books and folios
5. Organizing events/activities
6. Listening to music
7. Environmental actions
 The 2021
BESPREN KABATAAN AWARDS
Search for Outstanding Kabataang Santiagueño, Youth Organizations
and Most Outstanding Sangguniang Kabataan

V. MOST SIGNIFICANT ACCOMPLISHMENT/ACHIEVEMENT

A write up for the nominee’s most significant achievements and
accomplishments in the areas of any of the following: academic
excellence, leadership, community involvement and social responsibility. In
not more than 300 words.

Please see attached files…

Name and Signature of Nominator

 The 2021
BESPREN KABATAAN AWARDS
Search for Outstanding Kabataang Santiagueño, Youth Organizations
and Most Outstanding Sangguniang Kabataan

VI. OKS ESSAY

An essay written by the nominee. Maximum of 300 words.

As an Santiagueño Youth, how have you responded to the call and the challenges of
nation building and the impact of youth volunteering?
 The 2021
BESPREN KABATAAN AWARDS
Search for Outstanding Kabataang Santiagueño, Youth Organizations
and Most Outstanding Sangguniang Kabataan

VII. SUPPORTING DOCUMENTS

You may insert only photos of awards with descriptive captions (name
of honor/award, date, venue, and award-giving bodies), copies of
newspaper clippings, certificates or plaques.

Note:
- Only one (1) proof/supporting document shall be submitted for
each claim
- Supporting documents should not include minutes of the
organizational meetings, project evaluation reports, project
proposals, general plans of actions, calendar of activities.
- For certificates and newspaper clippings, photocopied materials
are preferred.

VIII. SUPPORTING CHARACTER REFERENCES*

We hereby certify that we have personally known the nominee,

JEMERSON L. EUGENIO, for at least two (2) years and to the best of
our knowledge, he/she is of excellent moral character and has no
record of criminal conviction or unfavorable disciplinary action at
school and to this organization.

MARJORIE S. MAGBITANG, MPA BETHLYZELLE ANICETO

Name Name

Office of Student Services and Affairs, University of La Salette, Inc. Immediate Past President, Rotaract Club of Santiago
Position/Designation Position/Designation

Echague, Isabela, Philippines Salaysay, Dubinan West, Santiago City, Isabela

Address Address

0917-514-7112 0977-279-0824
Tel. No. Tel. No.

__________________________________ __________________________________
Signature Signature

*must not include relatives

 The 2021
BESPREN KABATAAN AWARDS
Search for Outstanding Kabataang Santiagueño, Youth Organizations
and Most Outstanding Sangguniang Kabataan

SCHEDULE OF ACTIVITIES / TIMELINES

One (1) hard copy of duly accomplished nomination form and supporting
documents (bid books) should be submitted to Local Youth Development
Office (LYDO) not later than the date provided below:

Date Time Activity Person/s involved Venue

Opening of
2/F CEIPO
Nomination for
August 12, 2021 LYDO Secretariat / Office
8:00 AM Outstanding
(Thursday) TWG (Temporarily
Kabataang
LYDO Office)
Santiagueño Search

2/F CEIPO
Deadline of
August 23, 2021 LYDO Secretariat / Office
4:00 PM Nomination for OKS
(Monday) TWG (Temporarily
Search
LYDO Office)

2021 OKS
Deliberation of Screening Conference
August 24, 2021 Whole nominees Committee/Judges Room, Santiago
(Tuesday) Day
(Bid book judging) LYDO Secretariat / City Hall
TWG

2/F CEIPO
August 25, 2021 Posting of 2021 OKS LYDO Secretariat / Office
5:00 PM
(Wednesday) Finalists TWG (Temporarily
LYDO Office)

2021 OKS Conference

August 27, 2021 Whole OKS Finalists Panel
Screening Room, Santiago
(Friday) Day Interview
Committee/Judges City Hall

Bulwagan ng
August 31, 2021 Whole The 2021 BESPREN
2021 BKA Finalists Mamamayan,
(Tuesday) Day KABATAAN AWARDS
Santiago City