Republic of the Philippines

Surigao del Sur State University

Cantilan, Campus
Cantilan, Surigao del Sur
Telefax No. 086-212-5132
Website: www.sdssu.edu.ph

OFFICE OF THE SUPREME STUDENT GOVERNMENT

CERTIFICATE OF CANDIDACY

Name : _________________________ Age : ______________

College : _________________________ Course : ______________
Birthday : _________________________ Sex : _____________
Date of Filing: ______________________ Year Level: _____________

Position Applied for :

______________________ (First Priority)

_______________________ (Second Priority)

Name of Party:

__________________________________________________

a. Have you been elected for a position in the past? ___ Yes ___ No
If elected position what position?

b. Have you been a member of organization? ___ Yes ___ No

If yes, what organization/s?

________________________________________________________________
________________________________________________________________

I declare that the above details are true and correct.

_______________________________
Name and Signature of the Candidate

Recommending Approval:

______________________________ _______________________
College Dean SSG President

______________________________ ________________________
Guidance Counsellor ComSElec Chairperson

Approved:

MYRNA S. LOREN, MAED-Math

Head, Office of the Student Welfare and Development