EDSP Application Form

ANNEX B
Overseas Workers Welfare Administration

Education for Development Scholarship Program (EDSP)
Regional Welfare Office III
EVALUATION FORM
A. APPLICANT'S DATA B. OFW DATA
Name: ___________________________________________ Name of OFW: _____________________________________
Last First Middle Last First Middle
Birthdate: ___________________ Age: ______________ Occupation/Jobsite: _________________________________
Sex: Male [ ] Female [ ] Citizenship: _______________ Category: LB [ ] SB [ ] Sex: M [ ] F[ ]
Preferred Course: ___________________________________ Civil Status: S [ ] M [ ]
Preferred School: ___________________________________ Latest Date of OWWA Contribution: ___________________
__________________________________________________ Term of Contract: __________________________________
__________________________________________________ Relationship to Applicant: ____________________________
C. REQUIREMENTS
1. [ ] Application Form
2. [ ] Three (3) 2''x2'' 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 PSA) of applicant, if child of OFW (Original)
__ Birth Certificate (issued by PSA) of both applicant and OFW (if brother/sister of OFW) (Original)
__ Certificate of No Marriage (CENOMAR) from PSA (if OFW is unmarried) (Original)
5. [ ] Secondary School Record (Form 137) (Certified true copy) (For In-coming Grade 12 only)
6. [ ] Certification that applicant belongs to the upper 20% of the High School Graduating Class. (For In-coming Grade 12 only)
7. [ ] Certified True Copy of Grades - (General Weighted Average (GWA) not lower than 85% in all academic and non-
academic subjects during the last school year attended in full load. (No failing grades), ( For 2nd - 5th Year only)
8. [ ] Health Certificate
9. [ ] Certificate of Good Moral Character
10. [ ] Form 2C - Parent's Certification that the applicant has not previously availed of OFWDSP and has not
taken any post Secondary or Undergraduate/ College Units and not a Recipient of any scholarship grants
11. [ ] Course Curriculum
12. [ ] Grading system
13. [ ] Certificate of Registration
D. ALTERNATIVE/OTHER REQUIREMENTS:
_____________________________________________________________________________________________________
Received by: __________________________

Date: ________________________________
Evaluated by: Recommending Approval:
_______________________________ ______________________________
Head, Education and Training Unit Chief, Programs Services Division
Date: _____________ Date: _____________

APPROVED
_______________________________________________
OWWA Regional Welfare Office Director
___________________
Date
FORM 1
Overseas Workers Welfare Administration
Education for Development Scholarship Program (EDSP)
Regional Welfare Office III EDSP
APPLICATION FORM
(Note: PLEASE FILL OUT LEGIBLY) Application No.:

I. APPLICANT'S INFORMATION
Name: __________________________________________ High School Attended: ______________________________

Last First Middle ________________________________________________
Birthdate: ___________________ Age: _____________
Civil Status: ______________ Citizenship: _____________ School Address: ___________________________________
Permanent Address: _______________________________ ________________________________________________
________________________________________________
Contact Nos.: Landline: ____________ Mobile: __________ School Tel No.: ___________________________________
Email Address: ____________________________________ General Average in Senior HS: ______________________
No. of Sibilings: _____ Family Order: 1st [ ] 2nd [ ] 3rd [ ] Others: ______
II. PARENTS' INFORMATION

FATHER MOTHER
Name: ______________________________________ ______________________________________
Citizenship: ______________________________________ ______________________________________
Tribal Affiliation (if any): ______________________________________ ______________________________________
Highest Educational Attained:______________________________________ ______________________________________
Contact No.: Landline: ______________ Mobile: _____________ Landline: ______________ Mobile: _________
Email Address: ______________________________________ ______________________________________
Employment Data:
Occupation/Position: ______________________________________ ______________________________________
Employer/Company Name: ______________________________________ ______________________________________
Employer Address: ______________________________________ ______________________________________
Gross Monthly Income: ______________________________________ ______________________________________
I hereby certify that all information given above are true and correct to the best of my knowledge. I will also abide
with the policy of the program on the 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: _________________________________
FORM 2
A. HEALTH CERTIFICATE
HEALTH AGENCY : _______________________________________________

ADDRESS: : _______________________________________________
________________________________________________
DATE: _____________
TO WHOM IT MAY CONERN:

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) of the Overseas Workers Welfare Administration (OWWA) for the S.Y. ______________________.
_____________________________
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.
_____________________________
Principal / Guidance Counselor
C. PRINCIPAL'S CERTIFICATION
Name of High School : ___________________________________________________________________

Address: ______________________________________________________________________________
TO WHOM IT MAY CONCERN:

This is to certify that __________________________________________________ is a candidate for graduation
for the school year 2018-2019 and is classified within the upper 20% of the total ________________ graduating students.
Principal
D. APPLICANT'S CERTIFICATION
This is to certify that undersigned has not previously taken the EDSP Scholarship Qualifying Examination
and any post-secondary or undergraduate/college units(Incoming First Year) .
This is to further certify that NO ONE of my children has previously availed of the ODSP/EDSP/CMWSP.
Attested by:
_____________________________ _____________________________
Parent/Guardian Applicant
(Signature Over Printed Name) (Signature Over Printed Name)
E. PARENT'S CERTIFICATION
PARENT'S CERTIFICATION ON APPLICATION

FOR IMMIGRATION / NO DUAL CITIZENSHIP OF APPLICANT

This is to certify that my son/daughter ________________________________________________ is not a
holder of dual citizenship and has no pending application for immigration for the USA or any other country.
_____________________________
Parent/Guardian

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ANNEX B

Overseas Workers Welfare Administration

Received by: __________________________

Date: _ Date: _

(Note: PLEASE FILL OUT LEGIBLY) Application No.:

Name: ____________ High School Attended:

II. PARENTS' INFORMATION

HEALTH AGENCY : _______________________________________________

TO WHOM IT MAY CONERN:

for scholarship application.

B. CERTIFICATE OF GOOD MORAL CHARACTER

Name of High School : ___________________________________________________________________

TO WHOM IT MAY CONCERN:

TO WHOM IT MAY CONCERN:

PARENT'S CERTIFICATION ON APPLICATION

TO WHOM IT MAY CONCERN:

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