CSP | CHEDRO8

Personal Information

Last Name

First Name

Middle Name

Ext. Name

Birthdate

Place of Birth

Sex

Civil Status

Province

Street/Barangay

Town

District

Zip Code

Mobile No.

Facebook Name/Username

Family Background

FATHER

Deceased

MOTHER

Deceased

LEGAL GUARDIAN (If applicable. Do not reinstate your parent.)

No. of siblings in the family

Parent(s)/Guardian Annual Gross Income

Is your family a beneficiary of the DSWD's Pantawid Pamilyang Pilipino Program (4ps)?

YES

Academic Information

Applicant's Type

LRN

Year Level in AY2023-2024

Name of School Last Attended

GWA

Higher Education Institutions (HEIs) Offering Priority Degree Program/Course with CoPC/Recognition

Offered Priority Degree Program/Course with CoPC | Priority Degree Program/Course with Recognition

Are you enjoying other source of educational/financial assistance?

YES

Type of Scholarship

Grantee Institution/Agency

Other Information

Indigenous People (IP) - Ethnic Group ex. Ayta, Negritos, etc.

Please specify membership:

Solo Parent (Parent of Applicant)

Person with Disability (PwD)

If yes, select Type of Disability

Please specify:

ID Picture

Choose file

1x1 or 2x2 white background picture

Birth Certificate

Choose file

Report Card/Grades

Choose file

Proof of Income

Choose file

I hereby certify that foregoing statements are true and correct. Any misinformation or witholding of information will automatically disqualify me from the CHED Scholarship Program. I am willing to refund the financial benefits received if such information is discovered after acceptance of the award.

I hereby express my consent for the Commission on Higher Education to collect, record, organize, update or modify, retrieve, consult, use, consolidate, block, erase or destruct my personal data as part of my information. I hereby affirm my right to be informed, object to processing, access and rectify, suspend or withdraw my personal data and be indemnified in case of damages pursuant to the provisions of the Republic Act No. 10173 of the Philippines, Data Privacy Act of 2012 and its corresponding Implementing Rules and Regulations.

Numerical Value	Percentage Value
1.00	98.58
1.10	96.91
1.25	96.12
1.30	94.32
1.40	93.23
1.50	92.65
1.60	91.18
1.70	90.18
1.75	89.54
1.80	88.82
1.90	87.82
2.00	86.80
2.10	85.64
2.20	84.64
2.25	84.15
2.30	83.27
2.40	82.27
2.50	81.28
2.60	80.14
2.70	79.00
2.75	78.12
2.80	77.45
2.90	76.27
3.00	75.00

CHED Scholarship Program Application Form AY 2023-2024

Instructions: Fill in all the required information. Do not leave an item blank. If item is not applicable, indicate "NA".

Personal Information

Family Background

Academic Information

Other Information