FORM 1 Republic of the Philippines NOT FOR SALE
Application No._______________ Department of Labor and Employment (can be reproduced)
Overseas Workers Welfare Administration
Region
Programs Services Division
EDUCATION & TRAINING UNIT EDSP
CMWSP
APPLICATION FORM
SCHOLARSHIP / TRAINING PROGRAM APPLIED FOR:
[ ] Education for Development Scholarship Program (EDSP)
[ ] Congressional Migrant Workers Scholarship Program (CMWSP)
I. INFORMATION SHEET (Note: Please PRINT LEGIBLY)
1. Name: _____________________________________________ 2. Age___ 3. Birthdate _______4. Sex: F [ ] M [ ]
LAST FIRST MIDDLE
5. Permanent Address: _____________________________________________________ 6. Civil Status______________
Municipality / District: _______________________________ Zip Code: ____________ 7. Citizenship______________
8. High School Attended: __________________________________________________ 9. Tel No. _________________
10. School Address : ________________________________________________________ Mobile No._______________
[Link]. Average in 4th Year High School _____________________
12. PARENTS’ INFORMATION FATHER MOTHER
a. Name: _____________________________________________________ ______________________________________________________
b. Citizenship: _____________________________________________________ ______________________________________________________
c. Highest Education Attained: _____________________________________________________ ______________________________________________________
d. Tribal Affiliation (if any): _____________________________________________________ ______________________________________________________
e. Occupation: _____________________________________________________ ______________________________________________________
f. Employer Address: _____________________________________________________ ______________________________________________________
g. Gross Income:
No. of Siblings in the Family : _______ Family Order : 1st [ ] 2nd [ ] 3rd [ ] Others: _______
I hereby certify that all answers given above are true and correct to the best of my
knowledge. I will also abide with the policy of the program that selection of qualified examinees for
scholarship award after approval of the Administrator is final and unappealable.
Attested by:
Parent / Guardian Applicant
(Signature Over Printed Name) (Signature Over Printed Name)
Date: ____________________________
Republic of the Philippines
Department of Labor and Employment
Overseas Workers Welfare Administration
Region
Programs Services Division
EDUCATION & TRAINING UNIT
EVALUATION FORM
[ ] Education for Development Scholarship Program (EDSP)
[ ] Congressional Migrant Workers Scholarship Program (CMWSP)
A. APPLICANT’S DATA B. OFW DATA:
Name _____________________________________________ Name of OFW : _________________________________
Last First Middle Last First Middle
Age:___ Birthdate:_______ Citizenship________ Sex: M [ ] F [ ] Occupation/Jobsite : ________________________________
Category: LB [ ] SB [ ] SEX: M [ ] F [ ]
Relationship to OFW __________ [Link] _________________ Civil Status: S[ ] M [ ] Region: _____________
Preferred Course:_____________________________________ Latest Date of OWWA Contribution : ___________________
PreferredSchool:______________________________________ Term of Contract: _________________________________
C. REQUIREMENTS REMARKS
1. [ ] Application Form _______________________
2. [ ] Two (2) 2” x 2” recent & Identical Photos _______________________
3. [ ] Proof of OWWA Membership
__ Official Receipt of OWWA Contribution _______________________
__ OFW Verification Sheet issued by MPC _______________________
4. [ ] Proof of Relationship to OWWA-Member/OFW
__ Birth Certificate (issued by NSO) of applicant, if child of OFW _______________________
__ Birth Certificate (issued by NSO) of both applicant & OFW, if OFW's brother/sister (for CMWSP) __________________
__ Certificate of No Marriage (CENOMAR) from NSO (if OFW is unmarried) _______________________
5. [ ] Secondary School Record (Form 137) _______________________
6. [ ] Health Certificate _______________________
7. [ ] Certificate of Good Moral Character _______________________
8. [ ] Certification that applicant belongs to the upper 20% of the High School Graduating Class _______________________
9. [ ] Applicant’s Certificate of not having taken post secondary or undergraduate/ college units
and not a Recipient of any scholarship grant / has not taken the EDSP Qualifying Examination _____________________
10.[ ] Sworn Statement that applicant has no pending application for resident immigrant status
from any country & does not have dual citizenship ________________________
D. ALTERNATE/OTHER REQUIREMENTS :
__________________________________________________________________________________________________________
______________________________________________________________________________________________
_______________________________________
E. EVALUATION REPORT:
[ ] Eligible [ ] Not Eligible [ ] Lacking Documents
Received by: _______________________________ Evaluated by: __________________________
Date: _______________________________ Chief, Programs Services Division
Date: _____________________________
APPROVED:
OWWA Regional Welfare Office Director
Date
FORM 2
A. HEALTH CERTIFICATE
MEDICAL CLINIC : ________________________________________________________
ADDRESS : ________________________________________________________
________________________________________________________
DATE: __________________
TO WHOM IT MAY CONCERN:
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 Education for Development
Scholarship Program (EDSP) for the SY 2009 - 2010.
____________________________
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)
Date: _______________________
*********************************************************************************
C. PRINCIPAL'S CERTIFICATION
High School :________________________________________________
Address : ________________________________________________
TO WHOM IT MAY CONCERN:
This is to certify that ___________________________ is a candidate for graduation this March
2009. This further certifies that he/she belongs to the upper 20% of the graduating class numbering ____.
___________________________
Principal
(Signature Over Printed Name)
Date: ________________________
D. APPLICANT'S CERTIFICATION
TO WHOM IT MAY CONCERN:
This is to certify that the undersigned has not previously taken the Education for Development
Scholarship Program (EDSP) Qualifying Examination and any post secondary/vocational or
undergraduate/college units.
Attested by:
_________________________ ___________________________
Parent / Guardian Applicant
(Signature Over Printed Name) (Signature Over Printed Name)
***************************************************************************
E. PARENT'S CERTIFICATION ON APPLICATION
FOR IMMIGRATION / NO DUAL CITIZENSHIP OF APPLICANT
TO WHOM IT MAY CONCERN:
This is to certify that my son / daughter __________________________is not a holder of dual
citizenship and has no pending application for immigration to any country.
_________________________
Parent / Guardian
(Signature Over Printed Name)
