ENGINEERING RESEARCH AND DEVELOPMENT FOR TECHNOLOGY

(ERDT) SCHOLARSHIP PROGRAM Attach here 1 latest

College of Engineering, Central Luzon State University DOST-SEI passport size picture
Science City of Muñoz, Nueva Ecija
Telephone No. (044) 456-7208 Mobile No.: 09228903987
E-mail Address: erdt@clsu.edu.ph
passport size picture
APPLICATION FORM

TYPE OF SCHOLARSHIP APPLIED FOR:

ME MS DE PhD

Program of Study: Agricultural Engineering

Research Areas of Interest: (1) _________________________________________________________________

(2) _________________________________________________________________
(3) _________________________________________________________________

QUALIFICATIONS:
1. Must be a Filipino Citizen
2. Must not be over 45 years of age
3. Must have a BS degree in engineering or related field (for MS applicants)
4. Must have a MS degree in engineering or related field (for PhD applicants)
5. Must be in good health
6. Must not have criminal/administrative cases (NBI certification is required)
7. Must be enrolled as a full-time graduate student
8. Must not have other scholarship contract
9. Must be willing to render required service obligation equivalent to the length oftime
that the scholar enjoyed the scholarship- One year of service for every year of scholarship
or a fraction therof
10. Must have a full-time commitment to the scholarship

Deadline of Submission of Application: First Semester- April 30

Second Semester- September 15

………………………………………………………………………………………………………………………………………………………………………………..
CHEKLIST OF REQUIRED DOCUMENTS (for staff use only)

Birth Certificate
Certified True Copy of grades/ Transcript of Records with Grade Point Average
Recommendation letter from 3 past professors or supervisors (see attached sheet)
Narrative essays
If employed, must be recommended by the head of agency and secure permisiion to take a
leave of absence while on scholarship
Medical Certificate as to health status from a licensed physician indicating PRC License No.
Valid NBI Clearance
One passport size picture
Resume
PRC Rating if Board Passer
 INFORMATION SHEET

I. PERSONAL INFORMATION
a.
Last Name First Name Middle Name
b.
Permanent Address: No. Street City/Municipality Province
c.
Zip Code Region District Passport No. E-mail address
d.
Current Mailing Address
e.
Telephone Nos. (Landline/Mobile)
f.
Civil Status Date of Birth Age Sex
g.
Name of Parents (Father) (Mother)

Address

II. GRADUATE SCHOLARSHIP INTENTIONS DATA

New Applicant
a. University where you applied/intend to enrol
for graduate studies
b. Course/Degree

Lateral Applicant
a. University Enrolled in

b. Course/Degree

c. Number of units earned d. No. of remaining units/sems

III. CAREER/EMPLOYMENT INFORMATION

a. Present Employment Status: ( ) Permanent ( ) Contractual ( ) Probationary
( ) Self-employed ( ) Unemployed
a.1 For those who are presently employed
Position Length of Service

Name of Company/ Office

Address of Company/Office

E-mail Website

Telephone No. Fax No.

a.2 For those who are self-employed

Business Name

Address

Email/Website Tel. No.

Type of Business Years of Operation

*Once accepted into the scholarship program, the scholar must obtain permission to take a leave of absence
from his/her employer and become a full-time student. The scholar must submit a letter/ certification from
his/her employer agreeing to the leave.

b. CAREER PLANS (Write in a separate paper)

b.1. A narrative, not more than 1000 words, describing your current work or a project
(or research) that you worked on and your contribution towards the completion
of the project.
b.2. Future Plans (After Graduation)
b.3. For PhD applicants, a narrative describing your intended research area

IV. RESEARCH AND DEVELOPMENT INVOLVEMENT (last five years)

Use additional sheet if necessary.

FIELD AND TITLE OF RESEARCH LOCATION/DURATION FUND NATURE OF
SOURCE INVOLVEMENT

v. PUBLICATIONS (last five years)

Use additional sheet if necessary.
TITLE OF ARTICLE/PUBLICATION PLACE/YEAR OF PUBLICATION NATURE OF INVOLVEMENT

VI. AWARDS RECEIVED

Use additional sheet if necessary.
TITLE OF AWARD AWARD GIVING BODY YEAR OF AWARD

I hereby certify that all information given above are true and correct to the best of my knowledge.

Signature of Applicant

Date ___________________
 LETTER OF RECOMMENDATION
FOR ADMISSION TO ERDT SCHOLARSHIP PROGRAM

To be completed by the applicant (Please type or Print)

Name: ____________________________________________________________

Current Address: _________________________________________________________________

Degree program applied for: _____________________________________________________________

Start of graduate study: 1st semester 2nd semester AY ________-________

Note to applicant: Ask your recommender to enclose this form in an envelope, seal the envelope, and sign
across the seal. Submit the envelop with its seal unbroken with the rest of application materials to the
College of Engineering, Central Luzon State University, Science City of Muñoz, Nueva Ecija.

To be completed by recommender

Any pertinent information regarding the applicant and your evaluation of the applicant's ability to
undertake graduate studies and research will be held in strict confidence.

How long have you known the applicant? _____________________________________________________

In what capacity have you known the applicant? _______________________________________________

If the applicant was a student in some of your classes, what were these subjects? __________________

__________________________________________________________________________________________

What do you consider as the applicant's outstanding talents or strenghts in relation to graduate study?

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

What do you consider as his/her weakness or deficiencies in relation to graduate study? ____________

__________________________________________________________________________________________

__________________________________________________________________________________________
Please rate the applicant on the following characteristics in comparison with other students in the same
discliplines who are known to you and who have had more or less the same amount of training and
experience. (Indicate size of group with which applicant is being compared _______________________
and its educational level _____________________).
Above Below Inadequate
Excellent Average Average Average basis for
judgement
1. Intellectual ability
2. Academic preparation for proposed field of study
3. Motivation for proposed field of study
4. Originality, creativity & motivation
5. Analytical & problem-solving ability
6. Initiative and independence
7. Honesty & integrity
8. Conscientiousness & ability to work independently
9. Ability to work with others
10. Oral communication skills
11. Written communication skills
12. Emotional maturity
13. Potential as reseracher in the discipline
14. Potential as a teacher in the discipline

Additional information and comments about the applicants (please use a separate sheet of paper, if necessary).

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

I therefore strongly recommend recommend recommend with reservations do not

recommend the applicant for admission to graduate studies in your college.

Recommender's Printed Name: _______________________________________________________________________________

Recommender's Signature: _____________________________________ Date: ____________________________

Position: ______________________________________ Highest Educational Attainment: ______________________________

Name and Address of Organization: __________________________________________________________________________

*Note to recommender: Please enclose this form in an envelope, seal the envelope, sign across the seal, and return sealed
envelope to the applicant.