APPLICATION FOR ACADEMIC SCHOLARSHIP PRIVILEGES

Academic Year : Control Number :

Term : Date Applied :
GWA (preceding term) : Scholarship Entitled to :
Current Cost of Scholarship: Cost of Scholarship to Date:

Name
Program
Year Level
Date Originally Admitted to Scholarship Program
Evaluated and Endorsed for Approval

Instruction:

1. Accomplish this form and file with the Office of the Chief Finance and Administrative Officer with the endorsement from
the Chief Academic Officer five (5) working days after your confirmation to the scholarship program or within two (2)
weeks after the close of enrollment. Strictly observe due dates, otherwise, any privilege which the applicant may be
entitled to shall be deemed forfeited.

Guidelines:

1. Any privilege granted based on this application will be good for the current semester/term. It will be renewable the
following term, provided applicant still qualifies for entitlement thereto.
2. Any academic scholar will always maintain a good scholastic standing to qualify, to wit:
GWA of 1.00-1.20 (no grade below 1.50)
GWA of 1.21-1.45 (no grade below 1.70)
GWA of 1.46-1.70 (no grade below 2.00)
3. The academic scholar must carry a full load per term in accordance with the requirement of the program enrolled.
4. The privilege granted is conditioned upon the scholar’s faithful compliance with all the school rules and regulations as
well as those pertaining to the privileges availed. Any breach committed deemed punishable under the Student’s Manual
is a ground for the discontinuance of the scholarship granted.

I hereby certify that I have read and fully understood all the instructions herein set forth. Any violation
of the scholarship policies will be a ground for the discontinuance or cancellation of my privilege as a
scholar.

I consent to the processing of my personal information in connection with this scholarship application.

Signature over Printed Name

To be filled up by Billing, A/R, & Scholarship Section:

ACTION TAKEN

 Deferred  Denied  Approved

Reviewed by: Approved by:

______________________________ ________________________________
F-FAD-305 Rev.01 (08-01-22)
 Supervisor Chief Finance and Administrative Officer
Billing, A/R, & Scholarship Section

F-FAD-305 Rev.01 (08-01-22)