UCPB-CIIF Foundation, Inc.

17/F UCPB CORPORATE OFFICES, 7907 MAKATI AVENUE, MAKATI CITY 1209
Telephone:. 840-3266 FAX NOS.: 892-9648 AND 893-3369

COCO SCHOLARS
UCPB-CIIF FOUNDATION’S SCHOLARSHIP PROGRAM (COLLEGE DEGREE)
 
Last Name:_________________First Name______________Middle Name________________
Home Address:________________________________________________________________
Telephone Number/Cellphone Number:_____________________________________________
Date of Birth: Month__________ Day__________ Year__________ Age__________
Name & Address of High
School:_____________________________________________________________________
Years Attended:__________________________ Date of Graduation:____________________
Last Name of Father:______________ First Name:____________ Middle Name:____________
Last Name of Mother:______________ First Name:___________ Middle Name:____________
Number of Siblings:___________ and their names:
_______________________________ Date of Birth: M_______D_______Y_______
_______________________________ Date of Birth: M_______D_______Y_______
_______________________________ Date of Birth: M_______D_______Y_______
_______________________________ Date of Birth: M_______D_______Y_______
(Please use back page if more space is required)
Location of Coconut Farm:______________________________________________
Owner ( ) Tenant/Worker ( ) Size of Farm:______ hectares Number if Coconut Trees_____
School Applied for: ___________________ College Course Interested In:__________________

Requirements for application attached herewith, for all applicants:

1. Duly accomplished application form with 2x2 clear picture

2. Clear copy of Birth Certificate (PSA or local)
3. Certification as child of coconut farmer, tenant, farmworker or farm-owner (not more than 10 has)
signed by any of the enumerated below:

a. Coconut Development Officer, Provincial Manager, Regional Manager of the Philippine Coconut
Authority (PCA); or
b. Head of religious group (priest/head minister/pastor/imam) where applicant attends services; or
c. COCOFOUNDATION staff based on home visit.

4. Certificate of good moral character from the principal, guidance counselor or class adviser
5. Diploma or Certificate of Graduation issued by his/her High School
6. Endorsement from the Head of College (if incoming sophomore/junior)
7. Clear copy of the Permanent Secondary School Record (Form 137) showing General Average of 75%
or better
8. Clear copy of grades of previous semesters with GPA of 3.0 or its equivalent 75% and above (if
incoming sophomore/junior/senior)
9. Certificate of Indigency issued by the Office of the Punong Barangay
10. Clear copy of the National Career Assessment Examination or other examination required by the
Department of Education (If required by the MSU)
11. Clear copy of result of College Admission Test

From whom did you hear about the scholarship?

( ) Cooperative (name:_______________________________________________________________)
( ) PCA ( ) Partner School ( ) LGU/Barangay ( ) Church ( ) Cocofoundation Scholar
( ) High School ( ) CSO:_________________________________( ) Others:_____________________

I attest that the information given above is TRUE and CORRECT.

___________________________________ ____________________
Printed Name and Signature of Applicant Date