Republic of the Philippines

Department of Education
Region X
Division of Misamis Oriental
Tagoloan National High School
Tagoloan, Misamis Oriental
SUPREME STUDENT GOVERNMENT

SSG CANDIDATE APPLICATION FORM

1x1
Please submit this duly filled-up application form on or before February 26, 2014 together I.D PICTURE
with ALL of the following requirements:
WHITE
BACKGROUND
1. Photocopy of FORM 138 or Report Card
2. Endorsement letter signed by the class adviser
3. Endorsement letter signed by the student in your section.
4. PTA Receipts
5. Essay not more than 300 words (how do you define success).

LATE SUBMISSION & INCOMPLETE REQUIREMENT SHALL NOT BE ACCEPTED.

Instructions: Read the General and documentary requirements. Fill-in all the required information sincerely. Do not leave an item blank. If an item is not applicable, indicate “N/A”.

GENERAL INFORMATION
Name
Last Name ( First Name) (Middle Initial) (N.E)
Sex Male Female Citizenship
Home Address:

Date of Birth (mm/dd/yy): Place of Birth:

st
Grade/ Year 1 choice: 2nd choice:

GRADE 7 President President

GRADE 8 V-President V-President
3RD YEAR Secretary Secretary
Desired Treasurer Treasurer
Section Auditor Auditor
Position
Peace Officer Peace Officer
Public Information Public Information
Officer Officer
-------------------------------------------------------------------- -------------------------------------------------------------------------------

Year Level Year Level

Representative Representative

Mobile Number/s e-mail

*Highest Grade (3 )grading
rd
*Average Grade (3rd)grading
*Lowest Grade (3rd)grading *Average Grade (1st )grading
Curriculum type RBEC SCS SPA SPS TECH-VOC Others

EDUCATION
Name of School School Year Honors /Awards Received
Elementary:
1st year H.S :
2nd year H.S :
3rd year H.S :
MAJOR EXTRA-CURRICULAR ACTIVITIES ,INVOLVEMENTS & PARTICIPATION
Extra-Curricular Activities** Date

Continued……
 ORGANIZATIONAL AFFILIATION
Name of Organization** Position Held Date

*specify what the subject is

** Only major achievements done and major leadership involvement are recommended

FAMILY BACKGROUND
1 Father’s Name
2 Mother’s Name
(Last Name) (First Name) (Middle Initial) (N.E)
1 Occupation Company Name and Position Held
2 Occupation Company Name and Position Held
1 Status Age: Citizenship
2 Status Age: Citizenship
Name of Siblings Age Status Occupation
1
2
3
4
5
6

Essay. Please be concise, limit your essay within the space provided.

7. Describe yourself. What are your dreams and platforms to our school? Why do you want to be as SSG officer?
If you will win, how can this be of help to you?

I/ We hereby certify that all the information given here is true, correct and complete, and you are hereby authorized to
verify the same through an official inquiry if needed.

We understand that misinterpretation and withholding of information requested in the application form will be
sufficient reason for DISAPPROVAL OR CANCELLATION OF THE CANDIDACY.

__________________________
(Applicant Signature over Printed Name)

__________________________ ____________________________
(Father’s Signature over Printed Name) (Mother’s Signature over Printed Name)

______________________________
(Class Adviser’s Signature over Printed Name)

Form No.1 s. y 2013-2014