Republic of the Philippines

DEPARTMENT OF SCIENCE AND TECHNOLOGY

REGIONAL OFFICE NO. IV-A (CALABARZON)

April 15, 2019

QUALIFIERS

DEAR Qualifiers:

Congratulations! You passed in the 2019 DOST-SEI Undergraduate Scholarship Examination which you took last 21 October
2018 and hence, you qualified under RA 7687.

To be able to enjoy the scholarship, you are to pursue a 4- or 5-year Bachelor of Science (BS) degree program in any of the
priority fields of study at a state university or college or any private higher education institution that is recognized by Commission
on Higher Education as Center Excellence or Center of Development or with FAAP Level III accreditation for the BS program that
you intend to enroll in. Attached is the list of the priority S&T program for your reference.

In this regard, you are advised to report with one of your parents or your legal guardian on the schedule indicated below for the
Orientation on S&T Scholarship Policies and Signing of the Scholarship Agreement (SA):

Date/Time : 27 May 2019 (Monday)/ 8:00 am

Venue : 3rd Floor RFSQAC Bldg., DOST CALABARZON, Jamboree Road., Barangay. Timugan,
Los Baños, Laguna

Kindly bring the following requirements:

1. 1 pc. 2” x 2”, colored picture (with white background wearing semi-formal attire);
2. Photocopy of 2019 Community Tax Certificate or any government-issued ID (e.g. valid passport, GSIS ID, postal ID,
etc) of Parent/Legal Guardian;
3. Notarized affidavit of guardianship or special power of attorney (if legal guardian);
4. Black ballpen.

Upon receipt of this notice, please confirm your attendance (whether you are attending or not attending the above-cited
activity) by using the following format:

 Sample: ATTENDING
Mary Joy B. Cruz, RA 7687

Then, send your response through email: dost4aschoreply@gmail.com

For further inquiries, please call us at (049) 536 4894

Lastly, fill-out the enclosed Reply Slip and send/submit it via mail or email or bring before or on the day of Orientation.

We look forward to meeting you and your parent/legal guardian.

Very truly yours,

ALEXANDER R. MADRIGAL, Ph.D., CESO III

DOST Regional Director

Encl: List of DOST-SEI Priority S&T Courses

List of CHED COE/COD

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Postal Address: Jamboree Road, Brgy. Timugan, Telefax Nos: (049) 536-4997 (ORD) / 5013 (Tech)
Los Baños, Laguna 4030 4390 (RSTL) / 8091 (RML)
5005 (FAS) / 4894 (SCHO/SETUP)

Website: http://region4a.dost.gov.ph Email: dost4ascholarships@gmail.com

 REPLY SLIP

ALEXANDER R. MADRIGAL, Ph.D., CESO III

Regional Director
DOST Regional Office - CALABARZON

Dear Dr. Madrigal:

As one of those who qualified for the 2019 RA 7687, I wish to inform you that I am (please check)
☐ Availing of the RA 7687 Scholarship and attending the Orientation as scheduled.
☐ Deferring the scholarship in AY 2019-2020 because _______________________________________________________
Deferment of Scholarship award may be allowed for medical reasons only.
☐ Not availing of the scholarship because_________________________________________________________________
_________________________________________________________________________________________________
(Please state reason for not availing)

Moreover, please be informed that I will be enrolling in ___________________ at the ________________________________

(Course) (School)

Very truly yours, Attested By:

_______________________________ _________________________________________
Qualifier (Printed Name & Signature) Parent/Legal Guardian (Printed Name & Signature)

Reply may either be mailed to DOST Regional Office - CALABARZON, Jamboree Road, Timugan, Los Baños, Laguna, 4030
or sent through telefax no. (049) 536-4894
or e-mailed to: dost4aschoreply@gmail.com
Deadline for Reply: May 17, 2019 (Friday)

REPLY SLIP

ALEXANDER R. MADRIGAL, Ph.D., CESO III

Regional Director
DOST Regional Office - CALABARZON

Dear Dr. Madrigal:

As one of those who qualified for the 2019 RA 7687, I wish to inform you that I am (please check)
☐ Availing of the RA 7687 Scholarship and attending the Orientation as scheduled.
☐ Defering the scholarship in AY 2019-2020 because _______________________________________________________
Deferment of Scholarship award may be allowed for medical reasons only.
☐ Not availing of the scholarship because_________________________________________________________________
_________________________________________________________________________________________________
(Please state reason for not availing)

Moreover, please be informed that I will be enrolling in ___________________ at the ________________________________

(Course) (School)

Very truly yours, Attested By:

_______________________________ _________________________________________
Qualifier (Printed Name & Signature) Parent/Legal Guardian (Printed Name

Reply may either be mailed to DOST Regional Office - CALABARZON, Jamboree Road, Timugan, Los Baños, Laguna, 4030
or sent through telefax no. (049) 536-4894
or e-mailed to: dost4aschoreply@gmail.com
Deadline for Reply: May 17, 2019 (Friday)