picture application form - mtc.edu.ph · pdf fileaffiliation/practicum feescapita ......

Type of Grant ___ _____________________________________________________

Name of Applicant ___________________________________________________________________________ (Legal Name on Birth Certificate) Family Name Given Name/s Middle Name

NOTE: This form should be accomplished correctly and completely by the parents/ guardian of the applicant. PLEASE ANSWER THIS QUESTIONNAIRE CAREFULLY, COMPLETELY AND HONESTLY. Applications with INCOMPLETE INFROMATION AND WITHOUT THE REQUIRED DOCUMENTS will NOT be processed. Parents may be called for interview for clarification of the information given. PLEASE SUBMIT THIS FORM TOGETHER WITH THE FOLLOWING REQUIREMENTS IN A LONG BROWN ENVELOPE BY APRIL 21, 2012.

1. QUALIFICATIONS AND BENEFITS Grant Qualifications Benefits

MTC ASSIST Full WPA of at least 87.00, no grade <83.00 100% coverage on tuition and miscellaneous fees

100% coverage on RLE and affiliation/practicum fees

Financial assistance on book and uniform expenses

Financial assistance on living expenses

Annual Gross Family Income of P300,000 for family of four. In excess of four, per capita income of P75,000. Not committed any major offense Not a recipient of any private or public scholarship grant

MTC ASSIST Partial WPA of at least 85.00, no grade <83.00 100% coverage on tuition fees 50% coverage on miscellaneous fees 50% coverage on RLE and

affiliation/practicum fees

Annual Gross Family Income of P300,000 for family of four. In excess of four, per capita income of P75,000. Not committed any major offense Not a recipient of any private or public scholarship grant

Metrobank Foundation GWA of at least 85.00 100% coverage on tuition and miscellaneous fees


Semestral allowance

Annual Gross Family Income of P300,000 (parents/guardians) Not committed any major offense Not a recipient of any private or public scholarship grant

Megaworld Foundation (except for Nursing and HNCA programs)

WPA of at least 85.00, with no failing grade 100% coverage on tuition and miscellaneous fees


Semestral allowance of P10,000

Annual Gross Income of P300,000 (parents/guardians) Not committed any major offense Not employed with businesses that directly compete with Megaworld Corporation Not a recipient of any private or public scholarship grant

APPLICATION FORM

2” X 2” Picture

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2. REQUIREMENTS Parents’ /Guardian’s detailed personal letter about the family’s financial situation justifying the need for financial

assistance. One (1) 2x2, white background, most recent photograph of applicant. For Megaworld Foundation applicants: Two 2x2 and

one 1x2, white background, most recent photograph of applicant; and photograph of applicant with family/guardian. Print name at the back of the picture.

For employed parents: Income Tax Return of Certificate of Compensation Payment/Tax withheld for the previous year, Certificate of Employment and Compensation from (including bonuses, allowances and commissions). OFW’s must submit employment contract.

For self-employed parents: Submit Business/DTI Permit, detailed description of the business and an income and expenses financial statement of the previous year.

For parents not filling an ITR: Please indicate in the letter the reason for non-filing. Provide certified true copy of Certificate of Non-Filing from Bureau of Internal Revenue (BIR).

If parent/guardian is retired, submit retirement and/or pension voucher. Siblings and other relatives currently helping out with the expenses of the family including educational expenses may be required to submit the abovementioned documents.

Proof of latest electricity and water billing statement. If statement is registered under the applicant’s parents/guardian’s name, include an certification letter from property owner.

For incoming freshmen: Copy of grades from First Year to Fourth Year High School For Megaworld Foundation applicants: Certificate of Upper 10% Class Ranking of Graduating Batch from High School Principal For incoming II-IV: Certified True Copy of Grades beginning the student’s first semester of entry

Certificate of Good Moral Character from the Student Discipline Department or High School Principal/ Guidance Counselor, whichever is applicable

Vicinity Sketch of Residence. Draw a map that shows how to get to Manila Tytana Colleges form your house. Indicate major streets and landmarks. Put an “X” mark on the location of your house. See Page 13.

Certificates and/or Certification of Leadership, Extra/Co-curricular involvement of the Applicant.

Write the complete name of the applicant at the upper left hand corner of the brown envelope following this format: LAST NAME, GIVEN NAME, MIDDLE NAME

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(For MTC Assist Grant in Aid applicants only.)

LETTER OF UNDERTAKING

DR. SERGIO S. CAO President Manila Tytana Colleges Dear Dr. Cao: This is to formally signify my intention to apply for a scholarship grant from Manila Tytana Colleges. I understand that I have to complete all documentary requirements for my application to be considered, and I commit to submit all necessary supporting papers, including but not limited to, certified true copies of my parents’ statement/s of income tax return, statement of assets and liabilities, report of grades, certificate of good moral character, medical certificate, any other document that I may be required to submit. I agree to submit myself to the criteria established by the MTC Scholarships Department in the selection of qualified and deserving candidates and its procedures in the processing of my application. I understand that the decision of the Selection Committee is final and unappealable. If I am selected as a scholar of the Manila Tytana Colleges, I undertake to render service to either the Manila Tytana Colleges or any other subsidiaries or partner of the Metrobank Group of Companies if deemed necessary for a period equivalent to the number of years that I will enjoy the scholarship. Should I fail to comply with this service obligation, I understand that the College may pursue whatever legal remedies are available to it. Respectfully Yours, __________________________ ____________________________ Applicant Parents/ Guardian of Applicant (Printed Name & Signature) (Printed Name & Signature)

_______________________ Date

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Current Address: ( ) Home ( ) Dormitory/ Boarding House ( ) Living with Relatives

( ) Others Street Address: Barangay: City/ Municipality: Province: Zip Code: Permanent Address: (if other than address provided in current address) Street Address: Barangay: City/ Municipality: Province: Zip Code: Cost of one-way transport: (cheapest rate) PHp Means of Transport: (plane, boat or bus, etc.) How many times a month does the applicant

go home to specified permanent address? Date of Birth (mm/dd/yyyy) Place of Birth Gender Religion Nationality Civil Status E-mail Address Landline # Mobile #

ELEMENTARY LEVEL (use additional sheet if necessary) School / Location

Year Graduated General Average

Honors / Awards Received [include non-academic] SECONDARY LEVEL (use additional sheet if necessary.) School / Location

Year Graduated General Average

Honors / Awards Received [include non-academic] School Involvement and Position Special Trainings/ Workshops/ Seminars Attended

Type of High School (check appropriate option) ( ) Public General ( ) Public Special (science, arts, etc.) ( ) Public Vocational ( ) Private Barrio/ Barangay ( ) Private Sectarian ( ) Private Non-Sectarian Amount of tuition and other fees paid in Applicants’ senior year in high school? Did the Applicant enjoy any form of scholarship or financial aid in high school? If yes, please specify grant Total amount of grant received?

PERSONAL DATA

EDUCATION

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For applicants who are currently enrolled at MTC: Year Level Course Student No. Is the applicant staying in a boarding house or dormitory / or renting an apartment/ studio/ condominium unit, etc.? ( ) Yes ( ) No Monthly Board PHp Monthly Lodging PHp Who pays for board and/ or lodging fees? Relation to applicant

Mode of transport from Applicant’s current address to MTC? ( ) Family Vehicle Owned? ( ) Yes ( ) No ( ) Motorcycle/ Scooter If No, how was the vehicle acquired/ whose is it/ who owns it? ( ) Bicycle/ Walk Owner: ( ) Carpool ( ) Public Transport

TOTAL P ________________________ Is the Applicant a working student? ( ) Yes, Full Time ( ) Yes, Part Time ( ) No Name of Company/Employer: Name of Immediate Supervisor: Address: Telephone No.: Monthly Income: Is this business/company family owned? Who finances the Applicants’ schooling? (check all applicable means) ( ) Parents ( ) Self ( ) Scholarship, Name of Scholarship: Total Amount of Scholarship ( ) Educational Plan, Name of Company and Plan: Total Amount of Plan: ( ) Others (e.g. relatives, etc.) Estimated amount of financial support per semester: Does the Applicant have a passport? ( ) Yes ( ) No If yes, please provide passport number. Has the Applicant traveled outside the country in the last 5 years? ( ) Yes ( ) No If yes, who financed the trip? (check applicable item below) ( ) Parents ( ) Siblings ( ) Relatives ( ) Others, please specify:

Type of Public Transport (Residence-MTC-Residence)

No. of Rides

Unit Amount Total Amount

Tricycle / Pedicab Jeepney Bus MRT/ LRT Cab/ Taxi Others ____________

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Status of Parents Living Together Separated Single Father Deceased Mother Deceased

RELATION FATHER MOTHER Name Age Birth Date Permanent Home Address

Tel. No. Mobile No. Email Address Highest Educational Attainment School or College Living Abroad? (Yes or No) Previous Year’s Gross Income Amount of Income Taxes Paid (most recent) If employed Occupation/Position Employer Business Address Business Tel. No. Average Monthly Income Annual Additional Income (allowances, per diem, bonuses, etc.)

If self-employed Nature of work Number of years in business Annual gross income Annual net profit If unemployed Last company joined When Reason/s for being unemployed If not living with parents Name of Guardian: Relationship to applicant: Employer: Occupation/ Position Monthly Income Does he/she contribute to the family expenses? (Yes/No) If not, who is funding the house expenses? HOUSE COMPANIONS other than parents and siblings (use additional sheet if necessary)

RELATION Name Relationship to Student Age Civil Status Tel. No./Mobile No. Occupation/ Year or Level (if student)

Employer/ School Business Address Business Tel. No. Average Monthly Income Sharing with house expenses? Yes/No

FAMILY BACKGROUND

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BROTHERS AND SISTERS (use additional sheet if necessary) Total Number of Siblings: Number of Working Sibling/s: Number of Studying Sibling/s:

RELATION Sibling 1 Sibling 2 Sibling 3 Name Age Year of Birth Civil Status If with children, please indicate how many

Permanent Home Address Currently living with family? (Yes/No) If No, indicate if he/she is living abroad or not

Telephone No. Mobile No. Highest Educational Attainment School or College Received Scholarship? (Yes/No) School Fees per Year (if student) Occupation/Year or Gr. Level Employer Business Address Business Tel. No. Average Monthly Income Previous Year’s Gross Income Does any of the Applicant’s brothers/sisters/stepbrothers/stepsisters contribute to the family’s expenses? ( ) Yes ( ) No If Yes, is the contribution regular? ( ) Yes ( ) No What is the frequency of the contribution? ( ) Once a month ( ) 3-4 times a month ( ) Once every three months ( ) Twice a month ( ) Once every two months ( ) Others How much is the average contribution? P Who contributes? Does the Applicant have any relatives (whether here or abroad) who contribute in meeting the family expenses? ( ) Yes ( ) No If yes, how much is the average annual contribution? P If assistance is not in cash, what kind of help do they give? How many household help are living with or working for the family:

Number Total Monthly Salary Maid (s)

Houseboy(s) Yaya (s) Cook (s)

Gardener (s) Driver (s) Other (s)

Does the Applicant’s family have a security guard? ( ) Yes ( ) No If yes, ( ) Hired by the village/ condominium/apartment ( ) Hired by the family Monthly Salary

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Please provide the following data as completely and honestly as possible. Otherwise, the application will be considered INCOMPLETE, thus, will not be processed. Put NA if not applicable.

FAMILY INCOME (Annual Gross)

Combined Annual Pay (father, mother) PHp

Combined Annual Pay (brother, sister)

Income from Business

Income from Land Rentals

Income from Res/Bldg Rentals/Lease

Retirement Benefits/Pension

Commissions

Financial Support from Relatives

Bank Deposits

Others (Specify)

Total Annual Income PHp

FAMILY EXPENSES (Monthly)

House Rental PHp

Food & Grocery

Car Loan /Amortization (specify)

Other Loan Amortization (specify)

Transportation/Gasoline & School Bus

Education Plan Premiums

Insurance Policy Premiums

Health Insurance Premium

SSS/GSIS/PAG-IBIG Loans

School/Office uniform/ Clothing

School Allowance

Electricity, Water, Cable, Cooking Gas

Telephone/Cellphone

Internet fees (DSL, Broadband)

Medicines

Doctor’s fee/Consultation

Hospitalization

Recreation

Others (specify)

Total PHp

Sub-total x 12 months PHp

FINANCIAL STATUS (Please answer thoroughly)

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What are the sources of income of the household? (Please tick all the applicable items) ( ) Salaries or wages ( ) Remittances from abroad ( ) Practice of Profession (e.g. Lawyer) ( ) Commissions ( ) Business ( ) Real Estate Rentals ( ) Farms/ Haciendas/ Fishponds ( ) Retirement Pension ( ) Dividends/ interests/ earnings from investment ( ) Others Does the Applicant’s family have/own a business/home industry? What kind? No. of Employees Capital invested When was the business started? Annual Net Profit

Does the Applicant’s family have/own farmlands/ fishponds? No. of Hectares No. of harvests Type of crops/ fish produced No. of workers Approximate Net Profit per year PHp DEPOSITS

Type Bank Branch Balance Face/ Maturity Value

Savings Account Checking Account Time Deposits Stocks Government Bonds, including Treasury Bills

Foreign Currency Deposits Other Deposits

Note: If annual expenses are higher than annual income, please explain in your letter how you cover for the deficit. Does any member of the household have a credit card/s? ( ) Yes ( ) No If yes, which type/s of credit card/s (check all applicable) Foreign (e.g. American Express, etc.) Local Bank (e.g. Metrobank, BPI Express Credit, BDO, etc.) Local Store (e.g Department store debit cards, etc.)

Family Expenses (Annual)

School Tuition & Fees PHp

Withholding Tax

SSS/GSIS/PAG-IBIG Contribution

Insurance, Plans (per Year)

Others (specify)

Sub-total PHp

TOTAL ANNUAL EXPENSES PHp

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Does the Applicant’s family have any of the following household appliances and other possessions?

Appliances No. of working units

Year Acquired

Acquisition Cost

Balance to be Paid

Monthly Payment

Label/ Model/ Units

Air conditioner Stand/ Desk/ Ceiling/ Wall

Fan

TV Set CD/VCD/DVD Player Component Stereo

System

Karaoke/ Videoke Component

Camera (SLR, Automatic, Manual, or Digital, etc.)

Video or Movie Camera (Mini Cam Recorder. etc.)

Cellular/Mobile Phone Portable Electronic

Gadgets (iPod, iPad, PSP, DS, etc.)

Desktop Laptop

Electronic Computer Component (PS3, Family

Computer, Xbox, etc.)

Cordless Phone (not cellphone)

Gas/Kerosene/Electric Stove

Microwave/ Oven Toaster

Water Dispenser Refrigerator/ Freezer

Washing Machine/ Spinner/ Dryer

Flat Iron Electric Supplied Musical

Instruments

Non- Electric Instruments Facilities/ Services part of household expenses stored in the Applicant’s house/ residence 1. Number of Telephone Units (landlines not cell phones): DSL? (Yes/No) Wifi? (Yes/No) 2. Electric water pump/ tank ( ) Yes ( ) No 3. Mobile Phone Services: ( ) Post-paid Total Monthly Cost: ( ) Pre-paid Estimated Monthly Cost: Household members’ private life and pre-need insurance (exclude GSIS and SSS)

Name of Insurance

Relation to Applicant

Insurance/ Type/ Plan

Face Amount

Total Annualized

Premium

Company Applicant Beneficiary Yes No

OTHER DATA

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Cars and other motor vehicle owned or regularly used by the family

Make/Yr/Model Date Purchased Amt of Purchase Balance to be Paid Company/ Family Owned If the vehicle is company owned, please state who uses the vehicle and its relation to the applicant, what company and specific purpose does it serve?

USER COMPANY/ OWNER PURPOSE ___________________________________ __________________________________ ___________________________________ ___________________________________ __________________________________ ___________________________________ ___________________________________ __________________________________ ___________________________________ ___________________________________ __________________________________ ___________________________________

If vehicle is provided by company, a. Does the Applicant’s family own the company or stocks of the company? b. Is the car under a car loan? ( ) Yes ( ) No c. Does the company cover gas allowances? ( ) Yes, how much Php /month ( ) No Does the Applicant have other relative/s who help out in the finances? Yes No If Yes, Name/s What is their relation to the Applicant? How much money do they send monthly on the average? RESIDENCE Location House Apartment Others Rented? Owned? Size of Lot Floor Area in Square Meter a. If rented, how long have the Applicant stayed in this place? Monthly Rent b. If owned, name of owner Relationship to Applicant Acquired when Cost Acquired Present Market Value Amount of unpaid mortgage Monthly mortgage payment No. of bedrooms No. of baths/ toilets No. of heads in the household Helper/s? c. If neither owned nor rented house, name of owner Relationship to family Contributions, if any, to house owner Php d. Does the Applicant have/own other properties (residential/commercial, etc)?

Description Location/ Area (m2) Year Acquired Value at Acquisition Present Market Value

(as per tax declaration)

Yearly Net Income

__________________ ____________ _____ _________________ __________________ __________________ __________________ __________________ ____________ _____ _________________ __________________ __________________ __________________ __________________ ____________ _____ _________________ __________________ __________________ __________________

Does the Applicant earn income from these lots? ( ) Yes ( ) No If yes, PHp Is the amount included in the Income Tax Return? ( ) Yes ( ) No Does the Applicant have farm animals, agricultural machinery, motorized banca? ( ) Yes ( ) No of 13

Name Relation to Applicant

Company Position/ Designation

Contact Number

1. 2.

Note: Immediate and extended family are not allowed to be used as reference by Applicant.

Statement of the Student and his/her Family/Legal Guardian/s We hereby certify that all the data and information and documents submitted are accurate and complete. We understand that any misinformation and/or withholding of information will automatically disqualify the undersigned applicant from receiving any financial assistance, or subsidy, and may serve as a basis for the cancellation of the scholarship grant that may be awarded by the College. Furthermore, if such misinformation and/ or withholding of information on our part is discovered after the MTC Scholarship Grant has been awarded, it is to our knowledge that we will be required to reimburse full amount received thru the scholarship grant without prejudice to the filing of charges against us. Applicant (Signature over printed name)

Parent/Guardian (Signature over printed name)

Date

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES) ) s.s.

BEFORE ME, a Notary Public for and in the above jurisdiction, this day of , 20 personally appeared (Name of Parent, Legal Guardian) with Valid ID with ID No. issued at on , and (Name of Applicant if applicable), with Valid ID ID No. issued at on , known to me to be the same person(s) who executed the foregoing instrument and all attachments and acknowledge to me that the same is their/his true act and deed.

IN WITNESS WHEREOF, I have hereunto set my hand and seal on the date and place herein above stated.

Doc. No. Page No. Book No. Series of 20

REFERENCES

NOTARY PUBLIC

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VICINITY MAP FORM

Draw a map that shows how to get from your residence to MTC. State landmarks and names of major streets and use an “X” to indicate your house in the map.

Pres. Diosdado Macapagal Blvd., Metropolitan Park Pasay City Direct Line: (632) 859-0816 | Trunk Line: (632) 859-0888

Website: www.mtc.edu.ph

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