2020 OUTSTANDING STUDENTS OF GONZAGA

I. NOMINATION FORM

2020 OSG MUNICIPAL SECRETARIAT
Office of the Municipal Chief Executive
Municipality of Gonzaga
Cagayan Province, Region II

Gentlemen:

After reviewing the award rules, it is our pleasure to nominate:

Name of Nominee: _____________________________________
School: ________________________________________________
Level: _________________________________________________
Signature: _____________________________________________

to   the  2020   OUTSTANDING   STUDENTS   OF   GONZAGA  Search   Program.   We   hereby

certify that, to the best of our knowledge, the information contained in this nomination form
and the accompanying supporting documents are true and correct.

We hereby agreed to send our candidate, if selected, to the venue of the final interview by the
Board of Judges and to attend the Awards Ceremonies. We understand that the decision of the
Board of Judges is final and binding.

_______________________________________
School

_______________________________________
Address

_______________________________________
Signature over Printed Name of the Adviser/Student Affairs

_______________________________________
Signature over Printed Name of the School Head

_________________________________
Contact Number
 2020 OUTSTANDING STUDENTS OF GONZAGA
II. NOMINEE’S PERSONAL DATA

_________________________________________________________________________________________
Last Name First Name Middle Name Nickname

_________________________________________________________________________________________
Home Address Contact Number

_________________________________________________________________________________________
Date of Birth Age Civil Status Gender

FAMILY BACKGROUND

Name Age Profession/Occupation

Father: _______________________________________________________________________________

Mother: _______________________________________________________________________________

Brother/s: _____________________________________________________________________________

      _____________________________________________________________________________

      _____________________________________________________________________________

Sister/s: _____________________________________________________________________________

      _____________________________________________________________________________

      _____________________________________________________________________________

EDUCATIONAL PROFILE

School Attended Level/Course/Degree Inclusive Years

Elementary: ___________________________________________________________________________

High School: ___________________________________________________________________________

College: _______________________________________________________________________________

Others: ________________________________________________________________________________

HOBBIES AND INTERESTS
 2020 OUTSTANDING STUDENTS OF GONZAGA
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

III. MOST SIGNIFICANT ACCOMPLISHMENTS

Fill   in   the   tablets   with   your   three   most   significant   achievements   in   the   Ares   Academic
Excellence, Leadership and Social Responsibility. In not more than 150 words per achievement,
write a narrative explaining the reasons why you consider each significant.

For the Level column, use the appropriate legend:
I­   International   N­   National   R­   Regional   P­   Provincial   D­Division   M­   Municipal   C­
Congressional S­ School Level

1. ACADEMIC EXCELLENCE

Rank Most Significant Accomplishments Level

1.

2.

3.
 2020 OUTSTANDING STUDENTS OF GONZAGA
III. MOST SIGNIFICANT ACCOMPLISHMENTS

Fill   in   the   tablets   with   your   three   most   significant   achievements   in   the   Ares   Academic
Excellence, Leadership and Social Responsibility. In not more than 150 words per achievement,
write a narrative explaining the reasons why you consider each significant.

For the Level column, use the appropriate legend:
I­   International   N­   National   R­   Regional   P­   Provincial   D­Division   M­   Municipal   C­
Congressional S­ School Level

2. LEADERSHIP

Rank Most Significant Accomplishments Level

1.

2.

3.
 2020 OUTSTANDING STUDENTS OF GONZAGA
III. MOST SIGNIFICANT ACCOMPLISHMENTS

Fill   in   the   tablets   with   your   three   most   significant   achievements   in   the   Ares   Academic
Excellence, Leadership and Social Responsibility. In not more than 150 words per achievement,
write a narrative explaining the reasons why you consider each significant.

For the Level column, use the appropriate legend:
I­   International   N­   National   R­   Regional   P­   Provincial   D­Division   M­   Municipal   C­
Congressional S­ School Level

3. SOCIAL RESPONSIBILITY

Rank Most Significant Accomplishments Level

1.

2.

3.
 2020 OUTSTANDING STUDENTS OF GONZAGA
IV. NOMINEE’S ACADEMIC ACHIEVEMENT PROFILE

 The  Sequence  of   the  presentation  shall  follow  the  sequence  in  the  criteria for
judging.
 The dates shall be in chronological order from earliest to most recent.
 For the Level column, use the appropriate legend:
o International   N­   National   R­   Regional   P­   Provincial   D­Division   M­   Municipal   C­
Congressional S­ School Level
 ‘Reference   Page’   refers   to   the   page   of   the   supporting   document   for   the   listed
item.
 The chart below must be replicated for each school year.

School Year:
Rank, Name of Honor,
DATE Award Given Description of the Reference
Level
(mm­dd­yy) Received/Achievemen by achievement Page
t

NOTE: The nominee may delete the instruction above if more space is needed and may add more
rows if needed.
 2020 OUTSTANDING STUDENTS OF GONZAGA
V. NOMINEE’S LEADERSHIP ACHIEVEMENT PROFILE

 The  Sequence  of   the  presentation  shall  follow  the  sequence  in  the  criteria for
judging.
 The dates shall be in chronological order from earliest to most recent.
 For the Level column, use the appropriate legend:
o International   N­   National   R­   Regional   P­   Provincial   D­Division   M­   Municipal   C­
Congressional S­ School Level
 ‘Reference   Page’   refers   to   the   page   of   the   supporting   document   for   the   listed
item.
 The chart below must be replicated for each school year.

School
Year:
Description of Organized
DATE
Position, Name the Activity and by (if Beneficiary Referenc
(mm­dd­ Level
of the Activity  Your applicable (if applicable) e Page
yy)
Involvement )
 2020 OUTSTANDING STUDENTS OF GONZAGA
NOTE: The nominee may delete the instruction above if more space is needed and may add more
rows if needed.
 2020 OUTSTANDING STUDENTS OF GONZAGA
VI. NOMINEE’S SOCIAL RESPONSIBILITY ACHIEVEMENT PROFILE

 The  Sequence  of   the  presentation  shall  follow  the  sequence  in  the  criteria for
judging.
 The dates shall be in chronological order from earliest to most recent.
 For the Level column, use the appropriate legend:
o International   N­   National   R­   Regional   P­   Provincial   D­Division   M­   Municipal   C­
Congressional S­ School Level
 ‘Reference   Page’   refers   to   the   page   of   the   supporting   document   for   the   listed
item.
 The chart below must be replicated for each school year.

School
Year:
Description of Organized
DATE
Position, Name the Activity and by (if Beneficiary Referenc
(mm­dd­ Level
of the Activity  Your applicable (if applicable) e Page
yy)
Involvement )
 2020 OUTSTANDING STUDENTS OF GONZAGA
NOTE: The nominee may delete the instruction above if more space is needed and may add more
rows if needed.

VII. NOMINEE’S CHARACTER AND VALUES PROFILE

A. NOMINATION LETTER FROM THE NOMINATOR

For   the   Nominator,   please   summarize   the   reasons   why   you   believe   your   nominee   should   be
selected. Kindly limit to 300 words only.

B. RECOMMENDATION LETTER

Recommendation letter from a person (except relatives) with a deep knowledge of the personal
history of the nominee. He or she may be a mentor, counselor, community or church leader or any
person notable repute who has worked with the nominee. This letter must highlight the reasons,
circumstances, and experiences that make the nominee outstanding.

C. CERTIFICATE OF GOOD MORAL

VIII. SCHOLASTIC RECORDS

A. Transcript of Records/Form 137 (form 10) (refer to the search procedure)
B. Certification of General Weighted Average (refer to the search procedure)

IX. SUPPORTING DOCUMENTS

Follow the order listed in the profile.