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GIP Form A - Application Form Template

This document is an application form for the Government Internship Program (GIP) run by the Department of Labor and Employment Region VI. [1] It requests information such as the applicant's name, address, contact details, birthdate, gender, civil status, and educational attainment. [2] The applicant must certify that the information provided is accurate and that they have read and understood the program's guidelines. [3] The form is to be validated and any supporting documents received are noted for the applicant's file.

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4K views1 page

GIP Form A - Application Form Template

This document is an application form for the Government Internship Program (GIP) run by the Department of Labor and Employment Region VI. [1] It requests information such as the applicant's name, address, contact details, birthdate, gender, civil status, and educational attainment. [2] The applicant must certify that the information provided is accurate and that they have read and understood the program's guidelines. [3] The form is to be validated and any supporting documents received are noted for the applicant's file.

Uploaded by

iska iska
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd

Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT


Region VI
Document Number: FM-003-05.1 Revision No. 1 Effectivity: August 1, 2019

DOLE-GIP Form A

DOLE REGIONAL OFFICE 6


GOVERNMENT INTERNSHIP PROGRAM (GIP)
APPLICATION FORM
INSTRUCTION TO APPLICANTS:
Please fill-out all the required information in this form and attach additional documents, if necessary.
1. NAME OF APPLICANT:

Family Name First Name Middle Name


2. RESIDENTIAL ADDRESS: ATTACH 2X2 PHOTO WITH NAME AND
SIGNATURE TAKEN WITHIN THE LAST
THREE (3) MONTHS

Telephone No.:
Mobile Number:
E-mail Address:
3. PLACE OF BIRTH (city/province):
4. DATE OF BIRTH (mm/dd/yyyy): / /
5. GENDER Male Female
6. CIVIL STATUS Single Married Widow/Widower
7. EDUCATIONAL ATTAINMENT
INCLUSIVE DATES
NAME OF SCHOOL DEGREE OR DIPLOMA
From To

CERTIFICATION: I certify that all information given in this application are complete and accurate to the best of my
knowledge. I acknowledge that I have completely read and understood the DOLE-GIP Guidelines as embodied in
DEpartment Order No. 204, Series of 2019.

Date Signature of Applicant


FOR DOLE-RO/FO Use Only
Interviewed and validated by:

Name and Signature/Position Date

Documents Received:
Transcript of Records Form 137 / 138 Certification from Schools or
document/proof equivalent to
Barangay Certification Diploma this effect

Type of Disadvantaged Persons:


Persons with Disability Indigenous People Victims of Armed Rebel Returnee
(PWD) (IP) Conflict

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