(Updated March 27, 2019)

Don Mariano Marcos Memorial State University

La Union, Philippines PASTE 2” x 2” PICTURE HERE

CERTIFICATE OF CANDIDACY

Campus

To: The CAMPUS COMMISSION ON ELECTIONS or COMELEC

Sir/Madam:

Pursuant to the requirements of the COMELEC, the undersigned hereby files his/her certificate of
candidacy for the SBO (REGIONAL/PROVINCIAL/MUNICIPAL) elections for the Academic Year 2021-2022, and
states the following:
1. That his/her full name is also known
with the nickname .
2. That he/she announces his/her candidacy for the position of .
3. That he/she is officially enrolled in the College/Institute of
Department: .
4. That his/her complete address is .
5. That the name of the political party to which he/she belongs is .
6. That he/she has not incurred a FAILED, DROPPED, or INCOMPLETE grade in the last two (2)
semesters and/or mid-year term attended immediately preceding this election or appointment
7. That he/she must have a regular load of at least 18 units in all semesters attended and while in
office.

Student’s Signature

Enclosure:
1. Rating Slip for the two (2) semesters and/or mid-year term (if applicable) immediately
preceding the elections issued by the Registrar.
2. For candidates who will be on OJT and Practice Teaching this coming second semester of school
year 2021-2022, they must comply with Article I Section 4 of the uniform election rules and/or
Guidelines of DMMMSU SBO. (Enclosure: Checklist from the Department Chairman)
3. Certificate of Enrollment.
4. Scanned copy/photocopy of Valid Identification Card (front and back).
5. Certificate of Good Moral Character.

Received by:

Signature over Printed Name Signature over Printed Name

COMELEC Commissioner/Representative COMELEC Chairman

Recommended by:

Signature over Printed Name Signature over Printed Name

Department Chairperson College SBO Adviser

Noted:

Signature over Printed Name

SAS Facilitator/Head