SILLIMAN UNIVERSITY 6200 Dumaguete City

Application for: (please check appropriate box)

□ Entrance Honor Scholarship □ Special Scholarship/Financial Assistance

FULL NAME: Last First Middle

1st PRIORITY COURSE: 2nd PRIORITY COURSE: 3rd PRIORITY COURSE: MOBILE PHONE NO.: BIRTHDATE: AGE: RELIGIOUS AFFILIATION: GENDER: HOME ADDRESS: PHONE NO.: DUMAGUETE CITY ADDRESS: PHONE NO.: HIGH SCHOOL GRADUATED FROM: YEAR GRADUATED: NO. OF GRADUATES: GRADUATION HONOR/RANK: HIGH SCHOOL GRADE AVE.: (If continuing student): UNIT LOAD: TQPA:

Please list the awards, honors and citations you received in Grade12 (applicant for college), Grade 10 (applicant for grade 11), and Grade 6 (applicant for grade 7) and indicate inclusive years:

Year Award Nature/Description of Award

FATHER’S NAME : AGE OCCUPATION MOTHER’S NAME: AGE OCCUPATION NO. OF SIBLINGS : PARENTS’ COMBINED ANNUAL INCOME :

Sibling’s Name Age Highest Educational Attainment Current Employment Status

Aside from parents, state the other persons helping your studies while in Silliman: a) Relationship b) Relationship

In what way, Please check: ( ) School fees ( ) Board & Lodging ( ) Allowance ( ) Others

Name and address of two persons not related to you whom you know can honestly recommend you:

a) Address b) Address

I hereby certify that the above information is true and correct to the best of my knowledge and ability.

Signed: Date Filed: Applicant’s Signature

APPLICATION REQUIREMENTS

A. FOR ENTRANCE HONOR SCHOLARSHIP

1. Accomplish application form available at the Office of the Registrar and Admissions and at the SU website www.su.edu.ph 2. Certification from the Junior and Senior High School Principal stating the honors obtained and the number of graduates. 3. Photocopy of Form 138. 4. Photocopy of the Honors Certificate.

B. FOR SPECIAL SCHOLARSHIP AND FINANCIAL ASSISTANCE For First Year Applicants 1. Accomplished application form. On a separate sheet of paper, briefly write an essay about yourself, your goals in life and why you need this special scholarship and what it will mean to you if granted. 2. Photocopy of Form 138. 3. Certification of graduation rank from the SHS Principal reflecting the number of students in the graduating class. 4. Latest income tax return or Certification as non-filer from the local BIR of both parents. 5. Recommendations from two (2) uninterested reliable persons from his/her community but not politicians and relatives, stating the economic condition of the family. 6. Interview with 3 SAC members through Facebook messenger video call.

For UCCP Pastor’s Children 1. Accomplished application form. On a separate sheet of paper, briefly write an essay about yourself, your goals in life and why you need this special scholarship and what it will mean to you if granted. 2. Photocopy of Form 138. 3. Certification from the District Conference stating that her/his parent/s are practicing pastor/s to a local church (state the name & location of the church) and the duration of the appointment.

For United Methodist Ministers’ Children 1. Accomplished application form. On a separate sheet of paper, briefly write an essay about yourself, your goals in life and why you need this special scholarship and what it will mean to you if granted. 2. Photocopy of Form 138. 3. Certification of graduation rank from the SHS Principal reflecting the number of students in the graduating class. 4. Certification from the District Superintendent that will certify that the applicant is a son/daughter of an ordained minister of the United Methodist church (state the name & location of the church) and the duration of the appointment.

For Senior High School 1. Accomplished application form. On a separate sheet of paper, briefly write an essay about yourself, your goals in life and why you need this special scholarship and what it will mean to you if granted. 2. Photocopy of Form 138. 3. Certification of graduation rank from the JHS Principal reflecting the number of students in the graduating class. 4. Latest income tax return or Certification as non-filer from the local BIR of both parents. 5. Recommendations from two (2) uninterested reliable persons from his/her community but not politicians and relatives, stating the economic condition of the family. 6. Interview with 3 SAC members through Facebook messenger video call.

For Junior High School 1. Accomplished application form. On a separate sheet of paper, briefly write an essay about yourself, your goals in life and why you need this special scholarship and what it will mean to you if granted. 2. Photocopy of Form 138. 3. Latest income tax return or Certification as non-filer from the local BIR of both parents. 4. Recommendations from two (2) uninterested reliable persons from his/her community but not politicians and relatives, stating the economic condition of the family.

For Medical School 1. Accomplished application form. On a separate sheet of paper, briefly write an essay about yourself, your goals in life and why you need this special scholarship and what it will mean to you if granted. 2. Photocopy of Transcript of Record (TOR). 3. Photocopy of National Medical Admissions Test (NMAT) result. 4. Endorsement from the College Dean of SU Medical School. 5. Latest income tax return or Certification as non-filer from the local BIR of both parents. 6. Recommendations from two (2) uninterested reliable persons from his/her community but not politicians and relatives, stating the economic condition of the family.

For Continuing New Applicants 1. Accomplished application form. On a separate sheet of paper, briefly write an essay about yourself, your goals in life and why you need this special scholarship and what it will mean to you if granted. 2. Certified TQPA of 2.5 or better from the College. 3. Endorsement from the College Dean. 4. Latest income tax return or Certification as non-filer from the local BIR of both parents. 5. Certification from the District Conference stating that her/his parent/s are practicing pastor/s to a local church (state the name & location of the church) and the duration of the appointment. (for UCCP Pastor’s children) 6. Certification from the District Superintendent that will certify that the applicant is a son/daughter of an ordained minister of the United Methodist church (state the name & location of the church) and the duration of the appointment. (for United Methodist Ministers’ Children)

For more information on scholarship, please write to:

The University Registrar and Admissions Officer Silliman University Hibbard Avenue Dumaguete City Telephone No. (035) 422-6002 local 245-247 Telefax No. (035) 422-8880 Email: [email protected] / [email protected]

Student Scholarship and Aid Division Office of Student Services Silliman University 2nd Flr. Oriental Hall Dumaguete City Telephone No. (035) 422-6002 local 328 Email: [email protected]