College Student Council

CERTIFICATE OF 2” x 2” ID picture with white

CANDIDACY
background taken within
the last 6 months
with full and handwritten
name tag and signature over
printed name.
Computer generated
or photocopied picture
POSITION DESIRED: (Write only one desired position.) is not acceptable.
_______________________________________

I. PERSONAL INFORMATION
NAME: SEX: AGE:
(Surname) (First Name) (Middle Name) (Ext.)
COURSE AND MAJOR: YEAR&SECTION: GWA:
COLLEGE: CIVIL STATUS:
CITIZENSHIP: E-MAIL ADDRESS:
CONTACT NUMBER: BIRTHDATE: RELIGION:
HOME ADDRESS:
BIRTHPLACE: ETHNICITY:

II. LEADERSHIP EXPERIENCES

Note: Please indicate four or less most recent and relevant leadership experiences.
POSITION NAME OF ORGANIZATION SCHOOL YEAR
1.
2.
3.
4.

III. SEMINARS/TRAININGS ATTENDED

Note: Please indicate five or less most recent and relevant trainings or seminars if available.
TITLE OF THE SEMINAR/TRAINING VENUE SCHOOL YEAR
1.
2.
3.
4.
5.

IV. WRITE A BRIEF EXPLANATION ON WHY YOU WANT TO RUN FOR THE INDICATED POSITION

PLEDGE OF GOOD INTENTION AND FIDELITY

I, whose name appears above, a bona fide student of the Quezon Colleges of the North, Ballesteros, Cagayan, of good academic
standing and good moral character, hereby run for the position stated above.
It is that I pledge not to clench for power but for the service to cater the common good. I run for this position, unstrained but
voluntarily and whole-heartedly. I will play fairly and promise not to commit any forms of cheating against my opponent just to win. It
will be my responsibility to uphold peace and order, in myself, and towards others, inside and outside the school. I am a symbol of
responsibility and accountability as Quezonian, not by name, but through my words and deeds.

SIGNATURE OVER PRINTED NAME

Date Filed:
Evaluated by:

Electoral Board Representative, Screening Committee

Action Taken : ☐ Qualifed ☐ Disqualified ☐ Conditional ☐ Others, pls. specify:
Date :