Annex A

2024 DOST-SEI S&T Undergraduate Scholarships

REPLY SLIP

DR. TERESITA A. TABAOG

Regional Director
DOST Regional Office No. 1

Dear Dr. Tabaog:

As a qualifier for the 2024 DOST-SEI S&T Undergraduate Scholarships, I wish to inform
you that: (please check)

❑ I am availing of the scholarship and will attend the Orientation on my given schedule
with my parent/legal guardian.

❑ I am availing of the scholarship and will attend the Orientation on my given schedule
but WITHOUT my parent/legal guardian.

❑ I am undecided but will attend the Orientation on my given schedule with my

parent/legal guardian.

❑ I am undecided but will attend the Orientation on my given schedule WITHOUT my

parent/legal guardian.

❑ I am not availing of the scholarship due to: (Please indicate reason)

__________________________________________________________________________

__________________________________________________________________________

Very truly yours, Attested by:

ZIONEL EZRA G. LAROYA

_____________________________ GERMAN B. LAROYA
_________________________________
Qualifier Parent/Legal Guardian*
(Printed Name & Signature) (Printed Name & Signature)

JUNE 23, 2024

Date: ____________________________

*If with a legal guardian, submit a copy of an affidavit of guardianship.

Accomplished Reply Slip may be submitted via mail to:

DOST Regional Office No. 1, DMMMSU-Mid-La Union Campus, Catbangen, San
Fernando, Philippines

OR upload through this link: https://bit.ly/2024UGrad_ReplySlip_R1

Deadline of Submission of the Accomplished Reply Slip: June 28, 2024