Republic of the Philippines

PROVINCE OF PANGASINAN
OFFICE OF THE GOVERNOR
Lingayen

pRovtNctAL scHoLARSHtp pROGRAit (psp)

POLICIES AND GUIDELINES FOR ACADEMIC SCHOLARS A.Y.2021-2022

ARTICLE I
The Scholarship Offering
Section 1. General Description. The Provincial Scholarship Program (PSP) consists of financial assistance from the Provincial Government
of Pangasinan for the college education of financially-challenged but deserving graduating high school students.
Section 2. College Education, what it consists of. College education consists of completion of work, leading to any four-year or five-year
Bachelo/s degree in any government recognized institution of higher leaming in the country.
Section 3. Financial Assistance, what it consists of. The amount of ten thousand pesos (P1O,OO0. 00) every term or semester, i.e., twice
every academic year, shall be given as financial assistance to the scholar. lf the receiving school adopts a trimester program, the
assistance is given at the first and the third trimester. The basis of computation would be the General Weighted Average (GWA) of
the first trimester and the sum of the GWA of the second and third trimesters.
Section 4. Standard for maintaining scholarship benefits.
Par. a.) Every scholar, must, in every semester of schooling, maintain (1) a full, normal load. Full normal load is the required
number of units to be enrolled by the scholar every semester as provided for by his/her school's course curriculum;
(2) a GWA of eighty-five percent (85%), with no grade below eighty percent (80%) in all academic and
non-academic subjects.
Par. b.) ln highly technical courses like Engineering, Architecture, and Accountancy, a GWA of eighty-two percent (82%), with no
failing grade in any subject, shall suffice in order to be entitled to the same scholarship benefits for the ensuing semester.
Par. c.) Failure to meet the foregoing standards for any reason terminates the scholarship assistance.
Section 5. Effects of other scholarship grants/ assistance.
Par. a.) The scholar who is able to eam academic scholarship or some other kind of educational benefits or privileges from the
school itself, or other private sources, shall still continue to receive financial assistance ftom the provincial government of
Pangasinan. Where the scholar is a recipient of the Free Tertiary Education benefits for State Colleges and Universities,
he/she shall continue to receive the scholarship assistance.
Par. b.) The scholar shall be disqualified to receive scholarship assistance, if he/she receives from the government another
scholarship assistance other than the Free Tertiary Education package in which case the scholar will have to choose betweer
the PSP Academic Scholarship or the scholarship coming from another government agency.
Par.c.) When a scholarship slot is vacated or waived, the PSP Management, Evaluation and Excellence Committee reserves the
right to give it to the applicant who is next in rank, based on the qualification slandard. This applies to First Year scholars
onlY.

ARTIGLE II
The Selection Criteria
Section 1. Qualified Applicants. The following can apply for the scholarship assistance:
Par a.) He/She should have a General Weighted Average (GWA) of eighty-five percent (85%) or higher.
Par b.) He/She should be a graduating Senior High School student of a recognized secondary school by the Department of Educatior
Par c.) He/She should belong to an indigent family as indicated by a Social Case Study Report from the DSWD.
Par d.) He/She should present a certificate of good moral character (PSP Form 2).
Par e.) HeiShe should present a medical certificate attesting to his/her good health.

ARTICLE III
Forfeiture of Benefit
Section 1. The scholar will lose his/her scholarship in any of the following:
Par. a.) When he/she fails to meet the grade requirement.
Par. b.) When he/she fails to enroll during the term or semester he/she is qualified.
Par. c.) When he/she, for any reason, stops schooling for one (1) term or one (1) semester.
Par. d.) When he/she fails to submit his/her grade requirements for one (1) term or one (1) semester
Par. e.) \l/hen he/she avails of another government scholarship assistance other than the Free Tertiary Education package.

Section 2. Exemption. A scholar who is disqualified to pursue highly competitive quota courses but has passed the maintaining grade
Requirement of the Provincial Scholarship Program (PSP) may shifi to a related course in the same school, subject however to
the Provincial Scholarship Program Management, Evaluation and Excellence Committee (PSPMEEC's) review and approval.

ARTICLE IV
Submission of Application Requirements
Section 1. All applicants should comply with the one-time submission of complete scholarship application requirements either through
email: pangskolar?il2l@gmail.com or personally at the 1$ Floor Capitol Building, Lingayen, Pangasinan.
Section 2. Deadline of submission of complete scholaship application requirements for A.Y. 2021-2022 is on July 20, 2021.

ARTICLE V
Qualification Standard
Section1.ForA.y.2021-2022,duetothechallengesofthepandemic,theselectionforthetwohundredten(210)availableslotswillbebaser
on the following formula:

Population of Municipality/ City Total No. of Scholarship No. of slots

ft= x Slots Available per Municipality/City
Grand Total No. of Population of Pangasinan in 2015

Note: PSP Academic Scholarship Application Form may be reproduced. Page 1 of 3 lApril 2021)
PSP Form No. 1

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REPUBLIC OF THE PHITIPPINES
PROVINCE OF PANGASINAN
Lingayen
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PSP ACADEMIC SCHOTARSHIP APPLICATION FORM

I wish to apply for college scholarship assistance and enroll at _

(Name of school and address)

for the course effective Academic year 2021-2022.

ln support to my application, aftached are the following documenE:

1. Senior High School Fourth (Final) Grading Report Card with General Weighted Average (GWA) of 85% or higher
(Certified Photocopy by the Class Adviser)
2. Regular Medical Certificate from a licensed physician (Originat Copy)
3. Social Case Study Report from the Municipal/City Social Welfare & Development Office(Original Copy)
4. Certificate of Scholarship Eligibility/ Good Moral Character (PSP Form No. 2)
5. lndividual lnformation Sheet (PSP Form No. 3) with recent picture. (Iaken within the last six (6) Months)

I hereby authorize the Provincial Scholarship Program Management, Evaluation and Excellence Gommifter
(PSPMEEC) or its duly authorized representative, to investigate allfacts conceming my skills, habits, character, background and suct
other information pertinent to my qualifications.

I understand that any misrepresentation, falsification or any omission of such fact, of whatever nature, required by this
application shall be considered a sufficient cause for denial of my application or termination of my scholarship privileges if alread
granted.

lf accepted, I promise to abide by the rules and regulations, as embodied in the provisions of the Guidelines for PSP for
Academically Highly Competent College Students, which I have read and fully understood.

(Applicant's Signature over Pinted Name)

(Name and Address of SchoolGraduatedl

x
PSP Form No.2

CERTIFICATE OF SCHOLARSHIP ELIGIBILITY

This is to certiff that is a candidate for graduation

(Name of applicant)
from on
(Name of school and address) (Date of graduation)
under the and meets all the requirements for graduation.
(Academic T racl</ Strandl

This is to certi! further that he/she is of good moral character. He/ She is a recipient of the following academic and non-academic
awards and citations:

Award Received Level

Date
Title of Competition (Champion, Runner-Up (Municipal, Provincial,
(mm/dd/yy)
etc.) National, etc.)
1

2
3
4
5

TOTAL NO. OF GRADUATING SENIOR HIGH SCHOOL STUDENTS:

ATTESTED:

(Signature over Printed Name)

Class Adviser of Applicant

Date

Note: PSP Academic Scholarship Application Form may be reproduced. Page2 of 3lApril 2021)
PSP Form No.3
Please paste your 2x2
INDIVIDUAL INFORMATION RECORD
photo here

(Taken within the last six

months)

Name Gender:

Directions: Give what is being called for as accurately and honestly as you can. Any misrepresentation may disqualify you for the
scholarship. PART lll should be accomplished with the help of your parents or guardians.

PART I
1. Date of Birth (mm/ddiyear) Place of Birth
2. Present Address
3. Contact Number/s:
4. No. of years of stay in the present address

PART II
1. Name and address ofsecondary school

2. Classification of High School Curriculum, /_/General, l_Nocational, /_/ Special Program (Pls. specify)
3. Date of Graduation
4. Academic Honors Received
5. Non-Academic Honors Received
6. SpecialTalents and Skills

PART III
1. Father's Name Occupation
Gross lncome per month
Amount of lncome Tax paid for previous year

2. Mothe/s Name Occupation

Gross lncome per month
Amount of lncome Tax paid for previous year

3. Guardian's Name (if applicable) Occupation

Gross lncome per month
Amount of lncome Tax paid for previous year

4. What do you like to be someday?

What does your father like you to be?
What does your mother like you to be?
What do your teachers like you to be?
What do your friends like you to be?

5. How many brothers and sisters do you have?

Elementary: unior High School: Senior High School

6. What other means of income does your family have aside from those mentioned in questions 1 and 2?
Please list them below.
Other Sources of lncome Monthly lncome

7. ln at least 50 words, state your reason for applying for this college scholarship.

I HEREBY CERTIFY that the answers ATTESTED:

to the foregoing are true and correct.

(Applicant's signature above printed name) (Parent's/Guardian's signature above printed name)

(Date) (Date)

Note: PSP Academic Scholarship Application Fot, rnry b" ieproduced. Page 3 ol3lApril 2021)