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CMSP RIX Scholarship Form

This document is an application form for the Student Financial Assistance Program for the academic year 2025-2026 in the Philippines. It requires personal information, family background, and details about the intended school and degree program. The form must be submitted online between April 22 and June 30, 2025, and applicants must enroll in specified priority programs.

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dreytulang18
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20 views2 pages

CMSP RIX Scholarship Form

This document is an application form for the Student Financial Assistance Program for the academic year 2025-2026 in the Philippines. It requires personal information, family background, and details about the intended school and degree program. The form must be submitted online between April 22 and June 30, 2025, and applicants must enroll in specified priority programs.

Uploaded by

dreytulang18
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines

Office of the President


COMMISSION ON HIGHER EDUCATION
Baliwasan Chico, Zamboanga City
Email Address: chedro9@ched.gov.ph

APPLICATION FORM FOR STUDENT


FINANCIAL ASSISTANCE PROGRAM
SY- 2025- 2026
Instruction Action Taken
1. Print all entries Award No
2. Place X in the appropriate blank provided Date of Filing
3. Fill in the portions specified for the programs applied for Region
Province

SCHOLARSHIP
Full State Scholarship Program (Public School) Half-PESFA (Private School)
Half State Scholarship (Public School)
Full PESFA (Private School)
Received by Authorized Official

Printed Name & Signature


PERSONAL INFORMATION
Name:
(Last Name) (First Name) (Middle Name )
Age: _______ Sex: ____________ Status: ____________ Religion: __________ Citizenship: _______________
Date of Birth: ________________ Place of Birth: ___________________________________ Contact No. _____________
Mailing Address : _____________________________________________________________________________________
E-Mail Address : _____________________________________________________________________________________
School name (High School): _____________________________________________________________________________
School Address : _____________________________________________________________________________________
School Type : ( ) Public School ( ) Private School ( ) Vocational
General Weighted Average: ________ Date of Graduation: __________________ Rank in Class: ________________

FAMILY BACKGROUND
Father: ( ) Living ( ) Deceased Mother: ( ) Living ( ) Deceased
Name: ____________________________________ ________________________________________________
Address: _________________________________ ________________________________________________
Occupation: _______________________________ _______________________________________________
Educt'l. Attainment: __________________________ _______________________________________________
Member of Pantawid Pamilya ( ) YES ( ) NO Children:
Solo Parent ( ) YES ( ) NO PWD ( ) YES ( ) NO Condition: ________________________
Tribe Membership (Ex. Subanen, Tausug etc.) _______________________________________________________________
Total Parents Gross Income (Php. ____________________________ (ITR for 2024/2025 Attached): ____________________

Brothers/Sisters Enjoying Scholarship: Cert. of Tax Exemption from BIR:

Name Scholarship Course & Year

School intended to enroll in: _____________________________________________________________________________


Factor(s) that motivated you to choose your course: _________________________________________________________

Degree Program (Course) School


First Choice : ________________________________________ ______________________________________
Second Choice : _____________________________________ ______________________________________
SIGNED DECLARATION BY THE PARENTS / LEGAL GUARDIAN
I/We hereby certify to the truthfullness and completeness of information provided. Any misinformation of witholding
information may disqualify my/our child from CHED Scholarship program.

In connection with this application for financial aid, we hereby authorized CHED OSDS/CHEDRO 9 to conduct
a background check on the family finances as deemed necessary.

_________________________________ _____________________________________
Applicant's Signature Over Printed Name Parent's or Guardian's Signature Over Printed Name

NOTE: Fully accomplished form to be upnloaded to the CHED 9 Portal CSP Application link up to April 22-June 30, 2025.
Must enroll in priority programs only provided in CMO no. 07 S. 2023, Regional Priority Programs and
Gender and Development (GAD) otherwise said application maybe disapprove

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