Don Antonio O. Floirendo Sr. Foundation, Inc.

DAMOSA Building, Lanang, Davao City 8000, Philippines

T: 63 82 2352158 F: 63 82 2348202 Email: aoffoundation@anflocor.com

SCHOLARSHIP APPLICATION FORM

Instructions: 1. Please fill-out legibly in CAPITAL LETTERS.

2. Do not leave any item blank. Write N/A if information needed does not apply to you.
I. PERSONAL INFORMATION

SURNAME GIVEN NAME MIDDLE NAME

CITY ADDRESS
PROVINCIAL ADDRESS
AGE SEX CIVIL STATUS
DATE OF BIRTH PLACE OF BIRTH RELIGION
LANDLINE # MOBILE # MOBILE # EMAIL ADDRESS
II. EDUCATIONAL BACKGROUND
LEVEL SCHOOL ADDRESS HONORS/AWARDS
HIGH SCHOOL
ELEMENTARY
SCHOOL INTENDED TO NAME OF SCHOOL COURSE
ENROLL
FIRST CHOICE
SECOND CHOICE
Factor(s) that motivated you to choose your course:

III. FAMILY BACKGROUND

FATHER MOTHER
NAME
AGE
EDUCATIONAL ATTAINMENT
SCHOOL LAST ATTENDED
OCCUPATION
EMPLOYER
MONTHLY INCOME(support ITR)
BROTHERS & SISTERS: Please indicate if they are currently enjoying the AOFF scholarship
CIVIL STATUS MONTHLY
NAME AGE RELATIONSHIP OCCUPATION (REGULAR, EMPLOYER
STATUS CONTACTUAL,ETC.)
INCOME

IV. CHARACTER REFERENCE

NAME 1 2 3
ADDRESS
COMPANY
POSITION
CONTACT #

This is to certify that the foregoing information and statements are true and correct to the best of my
knowledge and that I am fully aware that any false information that I have intentionally or negligently
written can cause the disapproval/cancellation of my scholarship.

________________________________ ________________________________
Signature over printed name of the Applicant Signature over printed name of Parent/Guardian

QUALIFICATIONS
  Must be a graduate or a graduating student in High School with general average not lower than 85% and with no grade per subject
lower than 80%.
 Must be of good moral character and possesses leadership skills.
 Not have a history of drug and alcohol dependence and has never been charged in any court of justice.
 Willing to uphold the high standards set by the AOF Foundation with regards to academic, social and moral excellence.
R E Q U I R E M E N TS
Please follow these instructions carefully:
1. Only applications with complete requirements will be accepted and processed.
2. Enclosed all requirements in one (1) long brown envelope.
3. Write your full name on the upper right side corner (Surname, Given Name, MI)
4. Deadline of Submission:____________________
5. Provide the following:
QUANTITY DESCRIPTION
1 Certified True Copy from your school Applicant’s High School Report Card (Indicating 1st-3rd grading grades)
1 Certified True Copy from your school Applicant’s good moral certificate
1 Photocopy Applicant’s NSO Birth Certificate
1 original copy Applicant’s police clearance
1 Photocopy Applicants 4th year High School ID “back to back” with 3 specimen signature
1 Photocopy Both parents/Guardians’ Latest BIR Income Tax Return or BIR Tax Exemption
Certificate for non-taxable income earners
1 Original copy Parents’ certificate of employment stating monthly income and length of service
Written Exam Score:

Interview Rating : Final Score :

Orientation
SCHOLARSHIP PRIVILEGES AND CONDITIONS
The following are the privileges and conditions for those who will be accepted in our Scholarship Program after passing all the
screening procedures namely: Application Screening, Examination, Orientation:
a. Full payment on Tuition Fee and Miscellaneous Fees depending on the categorization of combined BIR Income Tax Return of
the family;
b. Monthly allowance of P4, 000 for dependents and P2, 000 for non-dependents; and
c. Book allowance of P2, 000 per semester.
Items b and c will be given directly by the foundation to the scholar concerned via deposit to his/her RCBC Savings Account.

Terms and Conditions of the Scholarship Grant:

a. Must submit prospectus of his/her course enrolled and shall carry the regular semestral academic load as specified in his/her
curriculum;
b. The scholar is required to maintain a General Weighted Average of B, 2.5and 85% during the semester. He/she must not have
a failing grade, Incomplete or dropped in any subjects;
c. The scholarship program shall be limited to only one qualified dependent of the employee during the whole term of the em-
ployees’ employment with the Anflo Group of Companies;
d. The termination, separation, resignation or retirement of the scholar’s parent from the Anflo Group of Companies will result to
change from dependent to non-dependent status of the scholarship grant of the scholar;
e. Must not commit fraud, dishonesty, crime, scandalous or immoral behavior nor violate the rules and regulations of the school;
f. The scholar is required to present his/her report card immediately after the end of a semester. Failure to present the same will
be ground for not granting the scholarship for the succeeding semester;
g. If the scholar paid his/her tuition fees/misc. fees in advance, the Foundation will not process reimbursement but the scholar can
claim their refund in school.
h. Failure to attend classes due to poor health, pregnancy, disciplinary action and any conduct which to our evaluation will contra-
dict to the objectives and standards of the Foundation and the School shall merit termination of the Scholarship Grant.

Violation of any of the terms and conditions aforementioned shall be considered as a ground for termination of the Scholarship
Grant.
Acknowledged by:
______________________________ ______________
Signature over printed name of Applicant Date
Affiliates:

For AOF Foundation Only

Remarks:
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________

Reviewed by: _____________________________________________ Date: _______________________

Approved by: _____________________________________________ Date: _______________________