Professional Documents
Culture Documents
_____District
PROVINCIAL GOVERNMENT of QUEZON
SERBISYONG SUAREZ SCHOLARSHIP PROGRAM
BENEFICIARY PROFILE
CERTIFICATE NO.________
Name _________
Last Name First Name Middle Name Nick Name Computer generated
or Xerox copy of picture
is not acceptable
______________________ ____________ ____________
Date of Birth Age Sex
Please indicate the full name of your organization/s. Please, indicate the nature of your organization/s e.g. religious, civic, Please indicate at least three major activities of
(e.g.: SK, SCAP, YFC, ROTARY, RED CROSS, cultural, sports, academic, student council, student publication, your organization/s had conducted in the past nine
BSP, GSP etc.) departmental organization, fraternity/sorority, community-based etc. months.
Requirements
I declare under oath that this form has been duly accomplished
o Accomplished application form with 2x2
Picture and is true, correct and complete statement. I hereby attest myself to
o Signed Letter of Intent abide by the rules and regulations of the Serbisyong Suarez Scholarship
o Brgy. Certificate of Indigency/Endorsement Grant Program with due respect to the organization and will
Letter from Brgy. Captain
o Endorsement Letter from the Mayor immediately release my scholarship upon reaching a demeanor as stated.
o Certified Copy of Grades
A. For incoming freshmen
– High School Report Card
B. For applicants with earned units in college _______________________
-Summary of Grades for the latest Signature
Semester attended signed by the school
Head/Dean/Registrar
o Certified copy of latest registration form/
enrollment form