OSS FORM NO. 1

Office of the President of the PhilippinesCOMMISSION ON HIGHER EDUCATIONHigher Education Regional Office ____

SCHOLARSHIP APPLICATION FORM

Instruction: Action Taken1. Print all entries Award No.2. Place an X in the appropriate blank provided Date of Filing3. Fill in the portions specified for the program applied for Region

ProvinceGRANT APPLIED FOR Cong. District

FULL MERIT DND-CHED PASUCHALF MERITTULONG DUNONG Others (pls. Specify)SNPLP Received by Authorized Official

PERSONAL INFORMATION Printed Name & Signature)

Name(Last Name) (First Name) (Middle Name)

Age: Sex: Status: Religion: Citizenship:Date of Birth: Place of Birth:Mailing Address: Telephone Number:Home/Provincial Address:School Name (High School):School Address:School Type: ( ) Public ( ) Private ( ) VocationalHighest Grade/Year: Date of Graduation: Rank in Class:National Career Assessment Examination (NCAE) Score: Date of Exam:Academic Awards/Honors Received:

NATURE/DESCRIPTION SCHOOL DATE

FAMILY BACKGROUNDFather ( ) Living ( ) Deceased Mother: ( ) Living ( ) DeceasedName:Address:Occupation:Educational Attainment:

For Tulong Dunong Applicants under the SP-IEPs: Certificate of Tribal Membership Total Parents Gross Income: (ITR for 200____ attached)Brothers/Sisters Enjoying Scholarship: No. of Children in the family

Name: Scholarship Course and Year

School Intended to enroll in:Factor(s) that Motivated you to chose your course:Programs and Schools

Degree Program (Course) SchoolFirst Choice :Second Choice:Third Choice :

(Printed Name Over Signature of Applicant)

CERTIFICATIONThis is to certify that from the Province of

Congressional District has been awarded a study grant/loan assistanceby the Commission on Higher Education through the CHEDRO to

enroll at effective School Year

Scholarship Coordinator

Note: Fully accomplished form to be submitted to the CHEDRO on or before April 30 Date

OPAPP-CHED Study Grant Program for Rebel Returnees

2 X 2ID PICTURE

OSS FORM NO. 2

MASTERLIST OF GRANTEES UNDER THE

CHED SPECIAL STUDY GRANT PROGRAM FOR CONGRESSIONAL DISTRICTS

_______ Semester, SY ______________

AWARD. NO.

NAME PERMANENT HOME ADDRESS

DISTRICT SCHOOL COURSE REMARKSLAST NAME FIRST NAME M.I. BRGY/STREET TOWN/CITY PROVINCE

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

Prepared by: Approved by:

Scholarship Coordinator Name of Representative

SEX

YEARLEVEL

OSS FORM NO. 3

WORK AND FINANCIAL PLAN FOR THE STUDENT FINANCIAL ASSISTANCE PROGRAMS (StuFAPs)ADMINISTRATIVE COST - AY 2009-2010

ACTIVITIES PERFORMANCE INDICATORS Total CostMONTH

Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec

1. Travelling Expenses

2. Supplies and Materials

3. Communication

4. Reproduction of Materials

5. Job Order (if needed)

TOTAL

Prepared by : Approved:

_____________________________ ___________________________

Regional Director

OSS FORM NO. 4

CHED REGIONAL OFFICE _____

CHED STUDENT FINANCIAL ASSISTANCE PROGRAMS (StuFAPs)STATUS OF BENEFICIARIES

___ Semester, SY _____-_____

PROGRAM CATEGORY NEW ON-GOING DEFERRED TERMINATED DROPPED WAIVED TRANSFERRED GRADUATES TOTAL

A. SCHOLARSHIP

1 FULL MERIT

2 NATIONAL SCHOLARSHIP PROGRAM (NSP)

3 STATE SCHOLARSHIP PROGRAM (SSP)

4

5 CHED - HEDP

6 HALF MERIT

7 REGIONAL SCHOLARSHIP PROGRAM (RSP)

8

9 PERSONS WITH DISABILITIES UNDER PESFA (PWD-PESFA)

10 PERSONS WITH DISABILITIES UNDER RSP (PWD-RSP)

B. GRANT-IN-AID (TULONG-DUNONG)

1 TULONG DUNONG

2 NATIONAL INTEGRATION STUDY GRANT PROGRAM (NISGP)

3

4 SCHOLARSHIP PROGRAM FOR INDIGENEOUS PEOPLE (SP-IEP)

5

6 DND-CHED-PASUC STUDY GRANT PROGRAM (DCP)

7

8 STUDY GRANT PROGRAM FOR SENIOR CITIZENS (SGSC)

9 ISKOLAR NG MAHIRAP NA PAMILYA (IMP)

10

11 CHED SPECIAL STUDY GRANT PROGRAM FOR SENATE (CSSGP-SENATE)

C. STUDENT LOAN

1 STUDY NOW PAY LATER PLAN (SNPLP)

TOTAL

Prepared by:

CHED SCHOLARSHIP PROGRAM FOR BRIGHT MINDANAOAN MUSLIMS (CSP-BMM)

PRIVATE EDUCATION STUDENT FINANCIAL ASSISTANCE PROGRAM (PESFA)

SELECTED ETHNIC GROUP EDUCATIONAL ASSISTANCE PROGRAM (SEGEAP)

OFFICE OF THE PRESIDENTIAL ADVISER ON PEACE PROCESS - CHED STUDY GRANT PROGRAM FOR REBEL RETURNEES (OPAPP)

STUDY GRANT PROGRAM FOR SOLO PARENT AND THEIR DEPENDENTS (SGSP)

CHED SPECIAL STUDY GRANT PROGRAM FOR CONGRESSIONAL DISTRICTS (CSSGP-CD)

Scholarship Coordinator

OSS FORM NO. 5.1

CHED REGIONAL OFFICE _____CHED STUDENT FINANCIAL ASSISTANCE PROGRAMS (StuFAPs)

STATUS OF BENEFICIARIES BY CURRICULUM YEAR LEVEL___ Semester, SY _____-_____

PROGRAM CATEGORYCURRICULUM YEAR LEVEL

I II III IV V VI TOTAL

A. SCHOLARSHIP - - - - - - -

1 FULL MERIT -

2 NATIONAL SCHOLARSHIP PROGRAM (NSP) -

3 STATE SCHOLARSHIP PROGRAM (SSP) -

4 CHED SCHOLARSHIP PROGRAM FOR BRIGHT MINDANAOAN MUSLIMS (CSP-BMM) -

5 CHED - HEDP -

6 HALF MERIT -

7 REGIONAL SCHOLARSHIP PROGRAM (RSP) -

8 PRIVATE EDUCATION STUDENT FINANCIAL ASSISTANCE PROGRAM (PESFA) -

9 PERSONS WITH DISABILITIES UNDER PESFA (PWD-PESFA) -

10 PERSONS WITH DISABILITIES UNDER RSP (PWD-RSP) -

B. GRANT-IN-AID - - - - - - -

1 TULONG DUNONG -

2 NATIONAL INTEGRATION STUDY GRANT PROGRAM (NISGP) -

3 SELECTED ETHNIC GROUP EDUCATIONAL ASSISTANCE PROGRAM (SEGEAP) -

4 SCHOLARSHIP PROGRAM FOR INDIGENEOUS PEOPLE (SP-IEP) -

5 -

6 DND-CHED-PASUC STUDY GRANT PROGRAM (DCP) -

7 STUDY GRANT PROGRAM FOR SOLO PARENT AND THEIR DEPENDENTS (SGSP) -

8 STUDY GRANT PROGRAM FOR SENIOR CITIZENS (SGSC) -

9 ISKOLAR NG MAHIRAP NA PAMILYA (IMP) -

10 CHED SPECIAL STUDY GRANT PROGRAM FOR CONGRESSIONAL DISTRICTS (CSSGP-CD) -

11 CHED SPECIAL STUDY GRANT PROGRAM FOR SENATE (CSSGP-SENATE) -

C. STUDENT LOAN - - - - - - -

1 STUDY NOW PAY LATER PLAN (SNPLP) -

TOTAL - - - - - - -

Prepared by: Noted:

Scholarship Coordinator Regional Director

TOTAL AMOUNT

OFFICE OF THE PRESIDENTIAL ADVISER ON PEACE PROCESS - CHED STUDY GRANT PROGRAM FOR REBEL RETURNEES (OPAPP)

OSS FORM NO. 5.2

CHED REGIONAL OFFICE _____

CHED STUDENT FINANCIAL ASSISTANCE PROGRAMS (StuFAPs)STATUS OF BENEFICIARIES BY DISCIPLINE

___ Semester, SY _____-_____

PROGRAM CATEGORY

BENEFICIARIES BY DISCIPLINE

BUSINESS ENGINEERING EDUCATION IT HUSOCOM MARITIME

A. SCHOLARSHIP - - - - - - - - - 1 FULL MERIT - 2 NATIONAL SCHOLARSHIP PROGRAM (NSP) - 3 STATE SCHOLARSHIP PROGRAM (SSP) - 4 -

5 CHED - HEDP - 6 HALF MERIT - 7 REGIONAL SCHOLARSHIP PROGRAM (RSP) - 8 - 9 PERSONS WITH DISABILITIES UNDER PESFA (PWD-PESFA) -

10 PERSONS WITH DISABILITIES UNDER RSP (PWD-RSP) -

B. GRANT-IN-AID - - - - - - - - -

1 TULONG DUNONG - 2 NATIONAL INTEGRATION STUDY GRANT PROGRAM (NISGP) - 3 - 4 SCHOLARSHIP PROGRAM FOR INDIGENEOUS PEOPLE (SP-IEP) - 5 -

6 DND-CHED-PASUC STUDY GRANT PROGRAM (DCP) - 7 - 8 STUDY GRANT PROGRAM FOR SENIOR CITIZENS (SGSC) - 9 ISKOLAR NG MAHIRAP NA PAMILYA (IMP) -

10 -

11 -

C. STUDENT LOAN - - - - - - - - -

1 STUDY NOW PAY LATER PLAN (SNPLP) -

TOTAL - - - - - - - - -

Prepared by:

SCIENCE AND HEALTH

RELATED

LEGAL AND CRIMINOLOGY

TOTAL BY CURRICULUM YEAR LEVEL

CHED SCHOLARSHIP PROGRAM FOR BRIGHT MINDANAOAN MUSLIMS (CSP-BMM)

PRIVATE EDUCATION STUDENT FINANCIAL ASSISTANCE PROGRAM

SELECTED ETHNIC GROUP EDUCATIONAL ASSISTANCE PROGRAM

OFFICE OF THE PRESIDENTIAL ADVISER ON PEACE PROCESS - CHED STUDY GRANT PROGRAM FOR REBEL RETURNEES (OPAPP)

STUDY GRANT PROGRAM FOR SOLO PARENT AND THEIR

CHED SPECIAL STUDY GRANT PROGRAM FOR CONGRESSIONAL DISTRICTS (CSSGP-CD)

CHED SPECIAL STUDY GRANT PROGRAM FOR SENATE (CSSGP-SENATE)

Scholarship Coordinator

OSS FORM NO. 5.3

CHED REGIONAL OFFICE _____CHED STUDENT FINANCIAL ASSISTANCE PROGRAMS (StuFAPs)

STATUS OF BENEFICIARIES BY GENDER___ Semester, SY _____-_____

PROGRAM CATEGORYGENDER

MALE FEMALE TOTAL

A. SCHOLARSHIP - - -

1 FULL MERIT -

2 NATIONAL SCHOLARSHIP PROGRAM (NSP) -

3 STATE SCHOLARSHIP PROGRAM (SSP) -

4 CHED SCHOLARSHIP PROGRAM FOR BRIGHT MINDANAOAN MUSLIMS (CSP-BMM) -

5 CHED - HEDP -

6 HALF MERIT -

7 REGIONAL SCHOLARSHIP PROGRAM (RSP) -

8 PRIVATE EDUCATION STUDENT FINANCIAL ASSISTANCE PROGRAM (PESFA) -

9 PERSONS WITH DISABILITIES UNDER PESFA (PWD-PESFA) -

10 PERSONS WITH DISABILITIES UNDER RSP (PWD-RSP) -

B. GRANT-IN-AID - - -

1 TULONG DUNONG -

2 NATIONAL INTEGRATION STUDY GRANT PROGRAM (NISGP) -

3 SELECTED ETHNIC GROUP EDUCATIONAL ASSISTANCE PROGRAM (SEGEAP) -

4 SCHOLARSHIP PROGRAM FOR INDIGENEOUS PEOPLE (SP-IEP) -

5 -

6 DND-CHED-PASUC STUDY GRANT PROGRAM (DCP) -

7 STUDY GRANT PROGRAM FOR SOLO PARENT AND THEIR DEPENDENTS (SGSP) -

8 STUDY GRANT PROGRAM FOR SENIOR CITIZENS (SGSC) -

9 ISKOLAR NG MAHIRAP NA PAMILYA (IMP) -

10 CHED SPECIAL STUDY GRANT PROGRAM FOR CONGRESSIONAL DISTRICTS (CSSGP-CD) -

11 CHED SPECIAL STUDY GRANT PROGRAM FOR SENATE (CSSGP-SENATE) -

C. STUDENT LOAN - - -

1 STUDY NOW PAY LATER PLAN (SNPLP) -

TOTAL - - -

Prepared by: Noted:

Scholarship Coordinator Regional Director

OFFICE OF THE PRESIDENTIAL ADVISER ON PEACE PROCESS - CHED STUDY GRANT PROGRAM FOR REBEL RETURNEES (OPAPP)

OSS FORM NO. 5.4

CHED REGIONAL OFFICE _____CHED STUDENT FINANCIAL ASSISTANCE PROGRAMS (StuFAPs)

STATUS OF BENEFICIARIES BY CONGRESSIONAL DISTRICT___ Semester, SY _____-_____

PROGRAM CATEGORYCONGRESSIONAL DISTRICT

1st 2nd 3rd 4th 5th 6th Lone TOTAL

A. SCHOLARSHIP - - - - - - - -

1 FULL MERIT -

2 NATIONAL SCHOLARSHIP PROGRAM (NSP) -

3 STATE SCHOLARSHIP PROGRAM (SSP) -

4 CHED SCHOLARSHIP PROGRAM FOR BRIGHT MINDANAOAN MUSLIMS (CSP-BMM) -

5 CHED - HEDP -

6 HALF MERIT -

7 REGIONAL SCHOLARSHIP PROGRAM (RSP) -

8 PRIVATE EDUCATION STUDENT FINANCIAL ASSISTANCE PROGRAM (PESFA) -

9 PERSONS WITH DISABILITIES UNDER PESFA (PWD-PESFA) -

10 PERSONS WITH DISABILITIES UNDER RSP (PWD-RSP) -

B. GRANT-IN-AID - - - - - - - -

1 TULONG DUNONG -

2 NATIONAL INTEGRATION STUDY GRANT PROGRAM (NISGP) -

3 SELECTED ETHNIC GROUP EDUCATIONAL ASSISTANCE PROGRAM (SEGEAP) -

4 SCHOLARSHIP PROGRAM FOR INDIGENEOUS PEOPLE (SP-IEP) -

5 -

6 DND-CHED-PASUC STUDY GRANT PROGRAM (DCP) -

7 STUDY GRANT PROGRAM FOR SOLO PARENT AND THEIR DEPENDENTS (SGSP) -

8 STUDY GRANT PROGRAM FOR SENIOR CITIZENS (SGSC) -

9 ISKOLAR NG MAHIRAP NA PAMILYA (IMP) -

10 CHED SPECIAL STUDY GRANT PROGRAM FOR CONGRESSIONAL DISTRICTS (CSSGP-CD) -

11 CHED SPECIAL STUDY GRANT PROGRAM FOR SENATE (CSSGP-SENATE) -

C. STUDENT LOAN - - - - - - - -

1 STUDY NOW PAY LATER PLAN (SNPLP) -

TOTAL - - - - - - - -

Prepared by: Noted:

Scholarship Coordinator Regional Director

OFFICE OF THE PRESIDENTIAL ADVISER ON PEACE PROCESS - CHED STUDY GRANT PROGRAM FOR REBEL RETURNEES (OPAPP)

OSS FORM NO. 6

REPORT ON GRADUATESAs of:

_______ Semester, SY ______________

___________________________________________________

(Program)

AWARD. NO.NAME

PERMANENT HOME ADDRESS

SCHOOL COURSEBRGY/STREET TOWN/CITY PROVINCE

LAST NAME FIRST NAME M.I. From To

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

Prepared by: Noted by:

Scholarship Coordinator Regional Director/OIC

SEX

Inclusive School year of Attendance

OSS FORM NO. 7

ANNUAL REPORT ON SNPLP BORROWERS_______ Semester, SY ______________

As of ______________

AWARD. NO.NAME

PERMANENT HOME ADDRESS

SCHOOLBRGY/STREET TOWN/CITY PROVINCE

LAST NAME FIRST NAME M.I. From To

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

Prepared by: Noted by:

Scholarship Coordinator Regional Director/OIC

SEX

COURSE

Inclusive School year of Attendance CO-

BORROWERPRINCIPAL

LOANEARNED

INTEREST

OSS FORM NO. 8

SCHEDULE OF SNPLP REPAYMENTSAs of ______________

AWARD. NO.NAME

REPAYMENTS

AMOUNT OR No. DateLAST NAME FIRST NAME M.I.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

Prepared by: Noted by:

Scholarship Coordinator Regional Director/OIC

SEX

CO-BORROWER

PRINCIPAL LOAN

EARNED INTEREST