NATIONAL YOUTH COMMISSION INTERNATIONAL PROGRAM

APPLICATION FORM

Not for Sale May be reproduced

INTERNATIONAL PROGRAM APPLYING FOR:

1. Surname: SABAL 2. Gender: [ M ] [ F ]

First Name: JHON LOUIE 3. Height: 53

Middle Name: BEQUISO 4. Weight: 50 kg 5. Age: 21
Nickname: Loi 6. Birthdate: 08 August 1993 7. Birthplace: Cagayan de Oro City

8. Current Address: Pilapil Compound, P5, Tablon, Cagayan de Oro City 9. Region: 10

10. Years of Stay: 5 years 11. Tel. No. (Landline/Area Code):None

12. Zip Code: 9000 13. Email Address: jlsabal@xu.edu.ph 14. Cellphone No: 0917-834-1259

15. Religion: Roman Catholic 16. Present Occupation/Position: Program Officer & Part Time Instructor

17. Name of Office: Xavier University 18. Office Address: Corrales Avenue, Cagayan de Oro City

19. Years in the Present Work: 5 months 20. Civil Status: Single





Passport-sized photo







Date Taken: January 2014


21. Number
0917-834-1259
Place of Issue:
Not yet
22. Type

Official General

23. Date of Issue


24. Date of Expiry


Emergency Contact
25. Name (Relationship):
Teddy L Sabal (Father)
27. Phone: 0927-845-9685
28. Mobile Phone:
26. Address:
Pilapil Compound, Purok 5, Tablon, Cagayn de Oro City
29. Fathers Name: Teddy L Sabal Place of Birth: Alubijid, Misamis Oriental Occupation: Real Estate Broker
30. Mothers Name: Gloria B Sabal Place of Birth: Laguindingan, Misamis Oriental Occupation: Public School Teacher
31. No. of Brother/s: None
32. No. of Sisterr/s: None
33. Educational Background Name of School/University Course / Inclusive Dates Honors Received
Elementary Tablon Elementary School 2001-2006 With Honors
Secondary Bugo National High School 2006-2010 Honorable Mention
Tertiary Xavier University-Ateneo de
Cagayan
2010-2014 Honorable Mention
Vocational
Post Graduate
34. Scholarship Grants Donor Inclusive Dates Honors Received
Cong Rufus B Rodriguez
Scholarship
Office of Cong Rufus
Rodriguez
2010 None
Fr Araneta Grant Xavier University 2011-2013 None

35. Youth Organization/Youth Serving Organization Affiliations:
Name of Organization Position Years of Membership Accomplishments
Young and Up Inc President 2 years Conducted Kab-ot training for
the youth of Xavier Ecoville and
created and re-strengthened the
Xavier Ecoville YouthClub
Xavier University EconomicsSociety President 4 years Conducted the First
Coffeenomics Series (the XU
version of TedTalks), conducted
the very first Mindanao Young
Economists Convention and won
5 major awards during the XU
Magis Awards 2014
Oro Youth Development Council Member 1 year Conducted trainings for OYDC
Lumbia and Iponan and helped in
the creation of OYDC Tablon
Ateneo School for Upcoming
Leaders
Alumni, Former Project Head of
Make a Smile 2011
3 years Created various trainings for
young potential student leaders
of Xavier University and
spearheaded the Make a Smile
2011 in response to the needs for
help during the Sendong
aftermath
36. Special Skills or Talents:
Public Speaking
37. Food Restrictions:
None
38. Allergies
None
39. Dialect(s) or Foreign Language(s) Spoken:
Cebuano, Filipino, English
40. Title of Seminar/Training Course Attended Inclusive Dates No. of Hours Conducted by
Political Education Program September 2014-Present 48 hours XU Governance and






Leadership Institute
Barangay Disaster Risk Reduction and
Management Training
September 2014 48 hours XU Governance and
Leadership Institute and
City DRRM Office
Bridging Leadership Training February 2013 48 hours Asian Institute of
Management
Change Leadership Training May 2013-February 2014 1 year training XU Student Activities and
Leadership Development
Office
41. Previous Work Experience

Name of Company Position Inclusive Dates Salary
Xavier University Ecoville Project Program Officer for
Organizational Development
May 2014-Present Php 19, 000
Xavier University Risk Reduction and
Management Program
Coach August 2014-Present Php 2,000 (Honorarium)
Xavier University Solid Waste Management
Program
Coach September 2014-Present Php 5,000 (Honorarium)
Xavier University Economics Department Part Time Instructor October 2014-Present Not yet
42. Character References: [not related to you within the third degree of consanguinity]

Name Occupation Address and Telephone No.
Dr Dixon Q Yasay Director of XU Governance and Leadership
Institute and Former Mayor of Opol, Misamis
Oriental
Opol, Misamis Oriental, 0920-945-9489
Mrs Catherine Roween C Almaden, MA Associate Dean of the XU College of Arts and
Sciences
Carmen, Cagayan de Oro City, 0908-899-9753
Mrs Marichu M Obedencio Chairperson, XU Department of Economics Cagayan de Oro City, 0917-792-4541

All facts and data given in this information sheet will be treated with utmost confidentiality

44. Have you previously applied for any NYC International Exchange Program? No Yes How many times? ________________

If yes, please indicate the program/s and year/s: ________________________________________________________________________


45. Have you been a participant of any NYC International Exchange Program? No Yes How many times? _______________

If yes, please indicate the program and year: _______________________________________________________________________

46. How did you know about the program?

Facebook: _____ Twitter: ______

Website: _____ E-mail from NYC: ______

Others [pls. Indicate]: _____________________________________________________

47. Have you availed of any program or scholarship grant offered by any foreign government? [ ] No [ ] Yes

If yes, please indicate the program, year, and name of organizer

48. Have you attended any seminar, conference or trainings abroad? [ ] No [ ] Yes

If yes, please indicate the program and year _______________________________________

49. Have you been involved with any NYC local program or activity? [ ] No [ ] Yes

If yes, please indicate the program(s) and year ______________________________________

50. Have you ever been convicted of any crime involving moral turpitude? [ ] No [ ] Yes

If yes, please indicate the nature and status
51. Do you have any pending case? [ ] No [ ] Yes

If yes, please indicate the nature and status

STATEMENT

I hereby certify upon my honor that all facts and information indicated herein are true and correct to the best of my knowledge. I further declare that
any information given by me that is untrue may constitute a disqualification to any NYC programs.

The undersigned expressly authorizes the National Youth Commission or its representatives to use, share, and process my personal information I
have provided, shared, or declared in this form for any lawful purpose.

Further, I subscribe and agree that the National Youth Commission has the sole prerogative to select and nominate the delegates to any
International Program, and its decision is final and executory.

IN WITNESS hereof, I am executing and signing this statement voluntarily without compulsion.

_____________________________
Signature

______________________________
Printed Name

NOTE:
The National Youth Commission reserves the right and prerogative to exclude applicants who will not meet the minimum requirements of the
Program. Lack or non-compliance of any of the above stated requirements will mean automatic disqualification without notice.
Mail or hand carry your application to the International Committee, National Youth Commission, 4
th
Flr., Bookman Building, 373 Quezon Avenue,
Quezon City, Tel No. 4162833.
Please fill out the form legibly