Republic of the Philippines

Cordillera Administrative Region

Provincial Local Government of
Ifugao Lagawe
Contact Nos. 09352375867/09208458563

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Instruction: :

1.) Name: 2) Sex: Male / Female

(Last Name) (First Name) (Middle Name)

3) Date of Birth: 4) Age: 5) Contact #:

6) Place of Birth:
7) Origin Municipality/s of Parents:
8) Present Address: 9) E-mail Address:
(Sitio) (Barangay) (Municipality)
10) Name of Father: 11) Contact #:
12) Name of Mother: 13) Contact #:
14) Name of Guardian: 15) Contact #:
16) Name of School you graduated: ) Year Graduated: 18) Average:
18) Name of School you intend to enroll in:
19) State Reason for Application:
20) Do you have brothers/sisters under TEAP Scholarship? Yes None
If yes, Please write their names below:
Name Course/Year School

Requirements to be attached in this form: (Please check if all the following requirements are accomplished before submitting).
1. Certified Photocopy of Form 138-A (grade 12)
2. Enrollment Assessment Form (EAF)
3. Certified Photocopy of Birth Certificate (from Local Civil Registrar)
4. Certificate of Annual Income of Parents from the Barangay Captain
5. Certification from the Punong Barangay that the applicant or any member of applicant’s direct family
is not a Current recipient of any scholarship or educational assistance of the Provincial Government.

Signature of Applicant

Criteria of Selection:
1. Must choose to enroll at any Public Tertiary Schools.
2. Must be a permanent resident of the Barangay.
3. Must have a weighted average of at least 75% upon graduation from high school.
4. Course must not exceed five (5) years.

Note:
1. The TEAP grant provides for a financial package of P3, 500.00 per semester to pay other miscellaneous expenses of
grantees.
2. Additional cash assistance for summer class (1,500.00) provided that it is required in the grantee’s curriculum.

3. All duly accomplished forms with the complete attachments must be submitted to the Provincial Administrator’s
Office particularly at the TEAP Section, Capitol Compound, Lagawe, Ifugao for review.