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Application Form For GKM-EAP

This document contains an application form for the Guimba Kong Mahal Educational Assistance Program (GKM-EAP). The application requests personal information from the applicant such as name, date of birth, address, contact details, and education information. It requires documents like birth certificate, barangay residency certificates, report cards, proof of enrollment, and financial documents to determine eligibility. Applicants must fill out the form personally and certify that all information provided is correct. The form will then be processed and reviewed by a screening committee.

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Camille Casuga
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51 views

Application Form For GKM-EAP

This document contains an application form for the Guimba Kong Mahal Educational Assistance Program (GKM-EAP). The application requests personal information from the applicant such as name, date of birth, address, contact details, and education information. It requires documents like birth certificate, barangay residency certificates, report cards, proof of enrollment, and financial documents to determine eligibility. Applicants must fill out the form personally and certify that all information provided is correct. The form will then be processed and reviewed by a screening committee.

Uploaded by

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

REPUBLIC OF THE PHILIPPINES


PROVINCE OF NUEVA ECUA
MUNICIPALITY OF GUIMBA

GUIMBA KONG MAHAL EDUCATIONAL ASSISTANCE PROGRAM (GKM-EAP)


APPLICATION FORM

Instructions: Fill in the required information in handwriting. DO NOT LEAVE an item blank. If the item is not
applicable, indicate “N/A”. All applications must be accomplished and filled PERSONALLY by the applicant. Please
write legibly.

I. PERSONAL INFORMATION
A. Surname:
B. Given Name: ID PHOTO
C. Middle Name:
D. Date of Birth: (month/day/year):
E. Age (at the time of filing):
F. Street/Purok: Taken within six (6) months
G. Barangay: prior to filing of application
H. Active Mobile Number:
I. Active Email Address:
II. EDUCATION
A. Name of School:
B. School Address:
C. Year Level:
Degree:
D. Educational Assistance Availed/Awarder for the current semester/academic year. Indicate if SPES
Beneficiary.
1. Title of Educational Assistance:
2. Awarder:

I hereby certify that all the information stated above are personally accomplished, correct and true.
__________________________________________________________________________________ _______________________________________________
Signature above printed name of the student Date Accomplished

To be processed by the screening committee:


a. Photocopy of Documentary Requirements:
Citizenship:
Birth Certificate (NS0, PSA)
Barangay Certificate of Residency of the student
Barangay Certificate of Residency of Parent
Academic Requirements
Report Card/Certificate of Grades from the latest semester attended with grading equivalence if
Grade point scale (4.00— 1.00) or Letter grade system (A-D):
Proof of Enrollment for the current semester
Financial Documents-any of the following:
Latest Income Tax Return (ITR) of parent or guardian
Certificate of Tax Exemption from the Bureau of Internal Revenue (BIR)
Latest copy of contract or proof of income may be considered for children of Overseas Filipino Workers
(OFW) and seafarers
Certificate of Employment of both parents

Processed by:

Signature above printed name Date Received

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