SCHOLARSHIP APPLICATION FORM

APPLICATION FOR GRADE 8, SCHOOL YEAR 2022-2023

Instructions: Please accomplish this form accordingly. Type or print legibly all information.
Recent 2" x 2"
DO NOT ABBREVIATE. DO NOT LEAVE ANY ITEM BLANK. Countersign all erasures and corrections made.
photograph

LEARNER'S REFERENCE NUMBER (LRN) with White Background

APPLICATION NUMBER (to be filled out by NAS)

PERSONAL INFORMATION

LAST NAME FIRST NAME MIDDLE NAME EXTENSION (Jr.)

DATE OF BIRTH GENDER AT [ ] BOY WEIGHT HEIGHT

(mm/dd/yyyy) ___/__/20__ BIRTH [ ] GIRL (in kilos) _______kg (in meters) _______m

EMAIL ADDRESS CONTACT NO.

Include all possible email Include all possible contact no.

HOME ADDRESS
House No./Lot/Building Street Name / Subdivision / Village Barangay

MUNICIPALITY/CITY PROVINCE REGION

[ ] NAS Social Media Page (facebook, instagram, twitter, etc.) [ ] News (TV, radio, etc.)
Where did you learn
[ ] Local Government Unit [ ] NSAs/Coach [ ] School [ ] NAS Employee / Student-Athlete
about NAS?
[ ] Other, please specify: __________________________________________________________________

Pursuant to: (a) Indigenous People's Act (RA 8371) and (b) Magna Carta for Disabled Persons (RA 7277), please answer the following:
a.) Are you a member of any indigenous group? [ ] Yes [ ] No b.) Are you a person with a disability? [ ] Yes [ ] No
(If your answer is YES, please show/attach evidence)

SPORTS (Accomplish Student-Athlete’s Profile Form for additional details)

[ ] AQUATICS [ ] ATHLETICS [ ] BADMINTON [ ] GYMNASTICS [ ] JUDO [ ] TABLE TENNIS [ ] TAEKWONDO [ ] WEIGHTLIFTING

SCHOOL INFORMATION

NAME OF SCHOOL SCHOOL TYPE [ ] PUBLIC [ ] PRIVATE [ ] OTHERS: _________

CONTACT NO. NAME OF PRINCIPAL

EMAIL ADDRESS NAME OF CLASS ADVISER

SCHOOL ADDRESS

CITY/MUNICIPALITY PROVINCE REGION

 PARENT’S INFORMATION

FATHER’S NAME CONTACT NO. EMAIL ADDRESS

ADDRESS

MOTHER’S NAME CONTACT NO. EMAIL ADDRESS

ADDRESS

[ ] FATHER [ ] MOTHER
DESIGNATED GUARDIAN
[ ] OTHER, RELATIONSHIP TO STUDENT: ______________________

GUARDIAN’S NAME CONTACT NO. EMAIL ADDRESS

ADDRESS

PARENTS/GUARDIANS’ DECLARATION AND CONSENT

TO BE FILLED OUT BY PARENTS/GUARDIANS

1. Is your child a Filipino citizen? [ ] YES [ ] NO

2. Does your child have a pending or approved application as an immigrant in any foreign country? [ ] YES [ ] NO

3. Has your child ever been subjected to academic or disciplinary action from any school attended? [ ] YES [ ] NO

If your answer to number 3 is YES, explain the details:

I certify that the above information is true and correct. I understand that any false or misleading information will make my child ineligible for
admission or be subject for dismissal. If my child is admitted, I agreed to abide by the policies, rules and regulations of the National Academy of
Sports.

For and in behalf of our minor child, I/we declare and confirm that, of our own volition, we submitted and may submit, necessary and needed
information and / or documents to the National Academy of Sports (“NAS”), with the intention of applying, and if qualified, enrolling our child for
the upcoming school year. In this regard, we acknowledge and understand that NAS needs our and our child’s personal and / or sensitive information
(collectively “Information”), so that it may, among others, verify our identity, evaluate our child’s academic requirements and eligibility, determine
our child’s physical fitness, and to enable NAS to communicate effectively with us.

We acknowledge and agree that:

1. NAS may disclose our Information with our consent or when so required or allowed by the relevant law, rules and regulations; and
2. NAS may use or store our Information with appropriate security measures for such period of time as our Information may be needed by NAS and
in accordance with relevant laws.

We also understand that:

1. We have the following rights with respect to our Information by notifying NAS in writing:
a) Inquire about, request to review or for a copy of our Information;
b) Update our Information;
c) Terminate the collection, use or processing or to delete our Information to the extent that such information is not necessary to NAS or is not
legally entitled to retain the same.
2. We may refuse to provide NAS our Information, or oppose its collection, recording, use, processing and storage but this would mean that NAS will
not be able to meet its purpose for collecting our Information.
We are aware that if we have any questions regarding the use and disclosure of our Information, including withdrawal of our consent, we may
contact NASCENT SAS Secretariat at nascentsas@deped.gov.ph.

By signing below, we acknowledge that we have read this document and understood the same, and that we are willingly giving our consent to the
collection, recording, use, processing, storage, sharing and transmission of our and our child’s Information, video, data or document, that we have
provided and may provide to NAS, as permitted by relevant data protection laws in the Philippines, including the Data Privacy Act of 2012.

____________________________________________ _________________________________________________
APPLICANT’S SIGNATURE OVER PRINTED NAME PARENT/GUARDIAN’S SIGNATURE OVER PRINTED NAME

DATE SIGNED: _____________________________ DATE SIGNED: ___________________________________

Submit via http://bit.ly/NASCENTSAS2022SubmissionForm or

email accomplished NAS Scholarship Application Form together
with Student-Athlete’s Profile, PAR-Q+ and other requirements to NASCENT SAS Secretariat at
email address: nascentsas@deped.gov.ph
Subject : NASCENT SAS 2022 Application for <Surname, First Name Middle Initial>