OWWA RWO3 ODSP Scholarship Form V-2.

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2020 Revision (Not For Sale)

Republic of the Philippines

OVERSEAS WORKERS WELFARE ADMINISTRATION 2x2
Regional Welfare Office 3 ID PICTURE

OFW Dependent Scholarship Program (ODSP)

APPLICATION FORM

Instructions: Fill in all the required information. Do not leave an item blank. If item is not applicable, indicate "N/A".
I. PERSONAL INFORMATION

Name
(Last Name) (First Name) (Middle Name) (Suffix)
Permanent Address

Present Address

Age □ Male Name of OFW Member:

Gender:
Date of Birth / / □ Female
Place of Birth Tel. No. Relationship to OFW:

Religion CP No. Category □ Landbased

Citizenship E-mail □ Seabased

II. FAMILY BACKGROUND
Father: □ Living □ Deceased Mother: □ Living □ Deceased No. of Siblings:

Name Address

Occupation Contact No.:

Educational Attainment E-mail:

III. EDUCATIONAL BACKGROUND

PERIOD OF ATTENDANCE
LEVEL NAME OF SCHOOL ACADEMIC AWARDS/SCHOLARSHIPS
FROM TO

Elementary

High School

College
IV. SCHOLARSHIP APPLICATION INFORMATION
School Intended to Enroll In

Course Year Level:

I hereby declare that the above information are true, correct and complete statement in compliance to policies and guidelines that governs the
OWWA Scholarship Program. I authorize the agency head or its authorized representative to verify/validate the contents stated herein.
I agree that any misrepresentation made in this document and its attachments shall cause the forfeiture of my scholarship application and/or grant.

(Signature over Printed Name of Applicant) (Date Accomplished)

V. EVALUATION (For OWWA)
Documents Attached:

□ OWWA Membership Information Sheet (Salary of OFW is not more than $600/month) □ Health Certificate
□ 2"x2" recent and identical photos (3 pcs / white backgroud) □ Certificate of Good Moral Character
□ Proof of relationship to OWWA-Member/OFW □ Parent's Certification
□ Authenticated Birth Certificate (PSA original copy) of applicant, if child of OFW □ Certified True Copy of Course Curriculum
□ Authenticated Birth Certificate (PSA original copy) of both applicant and OFW, if brother/sister of OFW □ Certified True Copy of Grading System
□ Certificate of No Marriage (PSA original copy) of OFW, if OFW is unmarried □ Certified True Copy of Certificate of Registration
□ Certified True Copy of Form 137 (Grade 7 to 12) with a General Weighted Average (GWA) of 80%
(For 1st year applicants only) Note: Additional requirements may be needed on a case to
□ Certified True Copy of Transcript of Records with General Weighted Average (GWA) of 80% and have no case basis.
failing grades in all academic and non-academic subjects during the last school year attended in full load □ Latest Verified Contract
(For 2nd - 5th year only)

Evaluated by: Recommending Approval: Approved by:

__________________________________ __________________________________ _________________________________

Evaluator, Education and Training Unit Chief, Programs and Services Division Officer-in-Charge, OWWA RWO3
FORM 2
A. HEALTH CERTIFICATE

HEALTH AGENCY : _______________________________________________

ADDRESS: : _______________________________________________
________________________________________________
DATE: _____________

TO WHOM IT MAY CONERN:

This is to certify that I have examined _____________________________
and found him/her to be:

Physically fit
Physically unfit

for scholarship application.

This certification is issued in connection with his/her application for the OFW Dependent Scholarship Program
(ODSP) for the S.Y. ______________________.
_____________________________
Medical Officer
(Signature Over Printed Name)
LC #: ________________________

B. CERTIFICATE OF GOOD MORAL CHARACTER

This is to certify that ________________________________ is of good moral character and that no disciplinary
action has been taken against him/her as of date.

_____________________________
Principal / Guidance Counselor
(Signature Over Printed Name)

C. PARENT'S CERTIFICATION

TO WHOM IT MAY CONCERN:

This is to certify that my son/daughter ______________________________________ has not taken any post
secondary/vocational or undergraduate/college units.(Incoming First Year).

This is to further certify that NO ONE of my children has previously availed of the ODSP/EDSP and not a
Recipient of any scholarship grant.
Attested by:

_____________________________
Parent/Guardian
(Signature Over Printed Name)