BLGF-RESA

REPUBLIC OF THE PHILIPPINES

Department of Finance Bureau of Local Government Finance
THIS FORM IS NOT FOR SALE

FORM B

NAME OF APPLICANT: ______________________________________________ POSITION: _________________________________________

SUMMARY OF TRAINING COMPLETED (IN CHRONOLOGICAL ORDER STARTING WITH THE MOST RECENT TRAINING) PUT A CHECK IF YOU ATTENDED TITLE OF TRAINING ACTUAL/ INCLUSIVE DATE
PARTICIPANT AS A

TRAINING OBJECTIVES AND BRIEF DESCRIPTION

RESOURCE SPEAKER

TRAINING ORGANIZER

TRAINING HOURS

CREDIT HOURS
(TO BE FILLED BY THE BLGF CENTRAL OFFICE)

REMARKS
(TO BE FILLED BY THE BLGF CENTRAL OFFICE)

TOTAL

To be filled by the BLGF Central Office

Date Processed: __________________________

Application No.: _______________________________

I HEREBY CERTIFY that the information stated herein are all true and correct that any false information or statement in this application and/or in the attachments thereto shall render me liable to criminal prosecution and/or administrative sanctions.

________________________________________________________________________________________________

BLGF ADMINISTERING STAFF (SIGNATURE OVER PRINTED NAME)

_________________________________________________________________ APPLICANTS SIGNATURE OVER PRINTED NAME

Note: Use additional sheet/s if necessary. This form may be reproduced/photocopied in several copies. Warning: All statements are subject to verification and any false statement or misrepresentation made in this form is a ground for disqualification and criminal prosecution pursuant to the provisions of R.A. No.9646 and PRC regulations.