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NSFD 2021 Application Form and Contract of Undertaking

This document is an application form for the National Scholarship for Development program from the Department of Justice of the Philippines. It contains information about the applicant Maria Anny G. Yanong such as her name, address, position, contact details, and the review classes and period covered for the scholarship. It also includes undertakings that she will adhere to program policies and allow her service to be dispensed with during the classes. The form is signed by the applicant and nominating supervisor. A contract of undertaking is also included which outlines the obligations of both the agency and grantee. The agency will authorize leave and pay for the applicant to take review classes and exams. The grantee must enroll, submit proof of enrollment and

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Anny Yanong
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205 views2 pages

NSFD 2021 Application Form and Contract of Undertaking

This document is an application form for the National Scholarship for Development program from the Department of Justice of the Philippines. It contains information about the applicant Maria Anny G. Yanong such as her name, address, position, contact details, and the review classes and period covered for the scholarship. It also includes undertakings that she will adhere to program policies and allow her service to be dispensed with during the classes. The form is signed by the applicant and nominating supervisor. A contract of undertaking is also included which outlines the obligations of both the agency and grantee. The agency will authorize leave and pay for the applicant to take review classes and exams. The grantee must enroll, submit proof of enrollment and

Uploaded by

Anny Yanong
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Revised Form 2009

Republika ng Pilipinas
KAGAWARAN NG KATARUNGAN
Department of Justice
Manila

APPLICATION FORM
National Scholarship Development

Name: Address:

Position: Cell/ Office Tel.

Office / Agency: Length of Service:

Review Classes to be taken: School:


 Law
 Engineering Period Covered:
 Accounting
 Thesis Writing No. of Leave applied:  yr/s.
 Others: (specify)  mo/s.

I hereby pledge to adhere the policies/ guidelines stipulated in Department


Circular No. 8 dated February 9, 2009.

______________________ MARIA ANNY G. YANONG


Date Signature over printed name

Nominating Immediate Supervisor / Head of Office


Applicant’s service may be dispensed with during the review classes.

JANET GRACE B. DALISAY-FABRERO


Regional Prosecutor
______________________________________________________________________

APPROVED:

__________________________________________

Republic of the Philippines


Department of Justice
National Scholarship for Development

CONTRACT OF UNDERTAKING

This Contract of undertaking made and entered into by and between:

The AGENCY, OFFICE OF THE CITY PROSECUTOR with office address at HALL OF JUSTICE
BLDG., ECOLAND, DAVAO CITY represented by RP JANET GRACE B. DALISAY-FABRERO and of legal
age.

The GRANTEE, MARIA ANNY G. YANONG, a permanent employee of DEPARTMENT OF JUSTICE,


OFFICE OF THE CITY PROSECUTOR holding a position of ADMINISTRATIVE ASSISTANT V of legal age and
a resident at Blk. 35, Lot 38, Phase 4, Mahogany Street, Green Meadows Subd., Tugbok District, Davao City
8000.

WITNESSETH:

A. OBLIGATION OF THE AGENCY


1. That the agency shall authorize the Grantee to take Review Classes and thereafter take the
Examination on official time covering the period from August 22- November 19, 2022;
2. That the Agency shall authorize the Grantee to draw his / her salaries and other emoluments
covering the aforesaid period with the assurance that the Grantee will continue to enjoy the benefits
which he / she may be entitles or may receive within the said period;
3. That the Agency shall not advance any payment for the duration of his / her study leave;
4. That the Agency shall terminate this contract of Undertaking upon proof that the Grantee has not
complied with his / her obligations as stated in the contract. In such event, the Agency compel the
Grantee to charge the number of days he / she has absented from work against her / his leave
credits, and if the Grantee has no leave credits, the Agency shall require the Grantee to pay an
equivalent amount for the number of days he / she was absent or on leave without pay.

B. OBLIGATION OF THE GRANTEE


1. That the Grantee shall upon the approval of the Contract, enroll in Review Classes and thereafter
take the BAR EXAMINATION covering the period of August 22- November 19, 2022;
2. That the Grantee shall submit to the Agency through the National Scholarship for Development
Secretariat the following:
a. Copy of the Official Receipt of enrollment of taken review classes.
b. Copy of Official Receipt of taken examination
3. That the service of the Grantee during the period requested may be dispensed with;
4. That the Grantee must render service obligation equivalent to _1___ (yr/s) ___0__(mo/s)

C. COMMON PROVISION
That both the Agency and the Grantee shall comply with the provisions of the Rules and
Regulations Implementing the national Scholarship for Development Program.

IN WITNESS WHEREOF, we have hereunder set our hands this ____ day of ___________ at
Davao City, Philippines.

JANET GRACE B. DALISAY-FABRERO MARIA ANNY G. YANONG


Head of Office / Agency (RP if Regional Offices) Grantee

ACKNOWLEDGMENT
Republic of the Philippines…..)
City/ Province of…………… ) s.s.

BEFORE ME, this _____ day of _______ in ________________, personally appeared the following:

Name Signature I.D. No. Issued at Issued on

1.
2.

Doc No. ________;


Page No.________;
Book No.________;
Series of 2022:

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