FORM 1 Republic of the Philippines NOT FOR SALE

Application (can be reproduced)

Department of Labor and Employment
No._______________ Overseas Workers Welfare Administration
Region 02
Programs Services Division EDSP
EDUCATION & TRAINING UNIT ODSP
APPLICATION FORM

SCHOLARSHIP / TRAINING PROGRAM APPLIED FOR:

[ ] Education for Development Scholarship Program (EDSP)
[ ] OFW Dependents Scholarship Program (ODSP)

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. College School Attended: _______________________________________________9.Tel No. _____________

10. School Address : ________________________________________________________Mobile No.__________

11.Gen. Weighted Average _____________________

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: _______
Name of OFW (If OFW is brother or sister): _______________________________
Relation to OFW : [ ] Brother [ ] Sister

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 02
Programs Services Division
EDUCATION & TRAINING UNIT
EVALUATION FORM
SCHOLARSHIP / TRAINING PROGRAM APPLIED FOR:
[ ] Education for Development Scholarship Program (EDSP)
[ ] OFW Dependents Scholarship Program (ODSP)

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 __________ Tel.No __________________ Civil Status: S[ ] M [ ] Region: _____________
Preferred Course:_____________________________________ Latest Date of OWWA Contribution : ______________
PreferredSchool:______________________________________ Term of Contract: _____________________________
C. REQUIREMENTS REMARKS
1. [ ] Application Form _______________________
2. [ ] Three (3) 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 ____________
__ Certificate of No Marriage (CENOMAR) from NSO (if OFW is unmarried) _______________________
st
5. [ ] Certification of Grades with General Average per semester since 1 Year college
Duly signed by the University/College Registrar _______________________
6. [ ] Health Certificate - see attached Form 2 _______________________
7. [ ] Certificate of Good Moral Character - see attached Form 2 _______________________
8. [ ] Certification of Enrolment SY 2017-2018 with School Assessment _______________________
st
9. [ ] Course Curriculum and Statement of Account with payment details since 1 Year
College to present _____________________
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 :
___________________________________________________________________________________________
Received by: CHRISTIAN VAN E. SALVADOR
Date:___________________

E. EVALUATION REPORT:

[ ] Eligible [ ] Not Eligible [ ] Lacking Documents

Evaluated by: LUZVIMINDA C. TUMALIUAN Recommending Approval: VIRSIE B. TAMAYAO
Head, Education and Training Unit Chief, Programs Services Division
Date: Date:
APPROVED:

__________________ PILIPINA C. DINO______________________

OIC, Regional Director

____________________________________________
Date
FORM 2
A. HEALTH CERTIFICATE
MEDICAL CLINIC : _________________________________________________________
ADDRESS : _________________________________________________________
DATE: ________________

TO WHOME 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)/ Congressional Migrant Workers Scholarship Program (CMWSP)/ OFW
Dependents Scholarship Program (ODSP) for the SY _________________.

_______________________
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.

______________________________________
College Guidance Counselor
(Signature Over Printed Name)
Date:___________________
***********************************************************************************
C. CERTIFICATION
School :________________________________________________
Address : ___________________________________________________
TO WHOM IT MAY CONCERN:
This is to certify that ______________________________________ is currently enrolled as BS
_______________________________________, _______ (year level ) of this university/college/this SY2017-2018

_________________________________
Registrar
(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)/ Congressional Migrant Workers Scholarship Program (CMWSP)/ OFW
Dependents Scholarship Program (ODSP) 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)