OFFICE OF STUDENT AFFAIRS

[ ] Main [ ] Branch
UNIVERSITY LEADERSHIP AWARD RANKING FORM

General Information

Name of the student: Date of filing:

College: Program:

Note: Please fill out the form for UM Leadership Award Ranking. Supply information in detail as indicated. Submit
additional sheets if necessary.

A. Academics 40%
GWA Academic Honors Points Score Equivalent x40%
1.00 – 1.50 Summa Cum Laude 100
1.51 – 1.80 Magna Cum Laude 90
1.81 – 2.00 Cum Laude 80

B. Student Leadership 60%.

TOTAL 100%
B.1 Awards and Recognition (35%)
B.1.1 No. of Awards Received (50pts)
Category No. of Awards Received Pts Score
3 and above 10
International Level
2 and below 5
4 and above 10
National Level
3 and below 5
5 and above 10
Regional Level
4 and below 5
5 and above 10
Local Level
4 and below 5
6 and above 10
UM Level
5 and below 5
Total

B.1.2 Rank/Place Attained (34pts)

Category Rank or Place Pts Score
Champion / 1st Place 10
International Level 1st Runner-up / 2nd Place 9
Others 8
Champion / 1st Place 9
National Level 1st Runner-up / 2nd Place 8
Others 7
Champion / 1st Place 8
Regional Level 1st Runner-up / 2nd Place 7
Others 6
Champion / 1st Place 7
Local Level 1st Runner-up / 2nd Place 6
Others 5
Champion / 1st Place 5
UM Level 1st Runner-up / 2nd Place 4
Others 3
Total

F-15400-014/ Rev. # 1/ Effectivity: October 18, 2019 Page 1 of 5

 OFFICE OF STUDENT AFFAIRS
[ ] Main [ ] Branch
UNIVERSITY LEADERSHIP AWARD RANKING FORM
B.1.3 List of Awards Attained (Use separate sheet if necessary)
Category Title of Event/Activity Date Place Documentary Evidence

B.2 Student Activities and Involvement (International/National/Local)

B.2.1.a List of Non-curricular Activities (UM-related Co-curricular/Extra-Curricular e.g. STREAM, STAR)
Particular Name of Activity Date Venue Documentary Evidence

B.2.1.b Role and Frequency of UM-related Activities Conducted/Participated (15pts)

Role No. of Activities Conducted/Participated Points Score
5 and above 5
Organizer/Facilitator
4 below 3
3 and above 5
Committee
2 below 3
10 and above 5
Participant 5–9 3
1 -4 1
Total

B.2.2.a List of Non-curricular Activities (External, Non UM-related)

Particular Name of Activity Date Venue Documentary Evidence

B.2.2.b Role and Frequency of External, NON UM-related Activities Conducted/Participated (20pts)
Role No. of Activities Conducted/Participated Points Score
5 and above 5
Organizer/Facilitator
4 below 3
5 and above 5
Resource Speaker
4 below 3
3 and above 5
Committee
2 below 3
10 and above 5
Participant 5–9 3
1-4 1
Total

B.3 Community Extension/Outreach

B.3.1.a Role and Frequency of Extension Programs – UM related (15pts)
Category Role No. of Extension Points Score
Core Committee 5 and above 10
Extension
Participant 4 and above 7
Core Committee 3 and above 5
Outreach
Participant 2 and above 3

F-15400-014/ Rev. # 1/ Effectivity: October 18, 2019 Page 2 of 5

 OFFICE OF STUDENT AFFAIRS
[ ] Main [ ] Branch
UNIVERSITY LEADERSHIP AWARD RANKING FORM

B.3.1.b List of Extension Activity

Role Title of Activity/Banner Date Venue Documentary Evidence

B.3.1.c List of Outreach Program

Role Title of Activity/Banner Date Venue Documentary Evidence

B.4 Student Officership

B.4.1.a Service (20pts)
Category Position School Year/s Points Score
Chair 5
Council of
Vice Chair 4
College/Department
Secretary 3
Student
Treasurer 3
Government
Others 2
Chair 5
Council of Vice Chair 4
College/Department Secretary 3
Student Org. Treasurer 3
Others 2
President 5
College Student/ Vice President 4
Department Secretary 3
Government Treasurer 3
Others 2
President 5
Vice President 4
Student
Secretary 3
Organization/Clubs
Treasurer 3
Others 2
Total

F-15400-014/ Rev. # 1/ Effectivity: October 18, 2019 Page 3 of 5

 OFFICE OF STUDENT AFFAIRS
[ ] Main [ ] Branch
UNIVERSITY LEADERSHIP AWARD RANKING FORM

B.4.1.b Years of Service (16pts)

Category Position Years of Service Points Score
Chair 2 years and above 5
Council of
Vice Chair
College/Department 1 year 3
Secretary
Student
Treasurer
Government
Others 1 year 1
Chair 2 years and above 5
Council of Vice Chair
College/Department Secretary 1 year 3
Student Org. Treasurer
Others 1 year 1
President 2 years and above 3
College Vice President
Student/Department Secretary 1 year 2
Government Treasurer
Others 1 year 1
President 2 years and above 3
Vice President
Student 1 year 2
Secretary
Organization/Clubs
Treasurer
Others 1 year 1
Total

B.4.2.a Service (External, non UM-related Group/Affiliation)(10pts)

Category Position School Years Points Score
President 5
Vice President 4
Any Civic/Religious/
Secretary 3
Others Groups
Treasurer 3
Others 2
President 5
Any Affiliated
Vice President 4
Group/Network/
Secretary 3
Professional
Treasurer 3
Organization
Others 2
Total

B.4.2.b Years of Service (External, non UM-related Group/Affiliation)(10pts)

Category Position Years of Service Points Score
President 2 years and above 5
Vice President
Any Civic/Religious/ 1 year 3
Secretary
Others Groups
Treasurer
Others 1 year 1
President 2 years and above 5
Any Affiliated
Vice President
Group/Network/ 1 year 3
Secretary
Professional
Treasurer
Organization
Others 1 year 1
Total

F-15400-014/ Rev. # 1/ Effectivity: October 18, 2019 Page 4 of 5

 OFFICE OF STUDENT AFFAIRS
[ ] Main [ ] Branch
UNIVERSITY LEADERSHIP AWARD RANKING FORM

C. Distribution of Percentages
Assigned Weights
Area
(WTS)
A. Academics 40%
B. Leadership 60%
B.1.1 No. of Awards Received 15%
B.1.2 Rank/Place Attained 10%
B.2.1.b Role and Frequency of UM-related Activities Conducted/Participated 5%
B.2.2.b Role and Frequency of External, NON UM-related Activities
5%
Conducted/Participated
B.3.1.a Role and Frequency of Extension Programs – UM-related 5%
B.4.1.a Service 5%
B.4.1.b Years of Service 5%
B.4.2.a Service (External, non UM-related Group/Affiliation) 5%
B.4.2.b Years of Service (External, non UM-related Group/Affiliation) 5%
Total 100%

D. Computation of Scores
Average Grade x
Highest Points Average Grade
Area Score Assigned Weights
(HP) { (Score/HP) x 100 }
(WTS)
A. 100
B.1.1 50
B.1.2 34
B.2.1.b 15
B.2.2.b 20
B.3.1.a 15
B.4.1.a 20
B.4.1.b 16
B.4.2.a 10
B.4.2.b 10
Total

Note: Nominated students must not have a grade of 5.0 (failed) and 9.0 (dropped) and must have no infraction
committed for him/her to be eligible of the University Leadership Award.

Validated by:

Evaluator

Noted by:

Head, OSA

Note: Kindly attach original and copies of evidences. Original copies will be returned.

F-15400-014/ Rev. # 1/ Effectivity: October 18, 2019 Page 5 of 5