Ateneo de Davao University

Application for Financial Aid

Undergraduate Programs
Please read the following thoroughly and follow these instructions carefully. An application checklist is also provided to assist you in tracking your
application progress. The documents you need to attach to your application and steps you need to follow are detailed in this form. You are given one
Recommendation Form (Page 7) which can be photocopied for the recommending persons below. Give a recommendation form to the person you
have asked to recommend you. Please be considerate enough to allow the recommending person sufficient time to complete the form.

Deadline of applications for the first semester study grant is on or before the last Friday of April. For second semester study grant, submit your
documents on or before last Friday of October.

STEP 1
SCHOLARSHIP REQUIREMENTS to ACCOMPLISH
Please attach the requirements and documents in proper sequence.
ANY OF THE REQUIRED DOCUMENTS ARE MISSING, YOUR APPLICATION WILL NOT BE PROCESSED AND WILL BE RETURNED TO YOU.
Submit your application materials in a brown envelope, with your name clearly written at the upper left corner in Surname, First Name format.
□ Completed “Application for Financial Aid” (Pages 2 – 6)
□ Photocopy of the Notice of Acceptance (NOA) from the Admission Director
□ Photocopy of Academic Records
 For Senior New High School / High School (old curriculum) Graduates: High School Report Card (DepEd Form 138A)
 For Transfer Students: Official Transcript of Records
 For Current Ateneo Students: Authenticated Collegiate Report Card of previous semester from the Registrar’s Office
□ Photocopy of Financial Income Documents
 For each presently employed parent and unmarried sibling residing with the family: Submit Certification of Compensation
Payment/Tax Withheld (BIR Form No. 2316)
 For OFW’s: Submit a photocopy of employment contract
 If parents are self-employed/own a business/home industry, submit the following: a) Detailed description of the nature of work or business;
b) Annual Income Tax Return (BIR Form 1700 or 1701); c) If applicable, photo of the building/establishment/place of business and paste
on a short bond paper
 If parents are retired or retrenched within the past 2 years: Submit a copy of the Certificate of Retirement or Separation with the amount
of retirement/separation benefits received
 If parent(s) are exempted from filing an ITR: Certificate of No Income.
□Clear PHOTOS of permanent residence: front view of the whole house and kitchen. Paste photos in Page 6 of Application for Financial Aid, duly
certified by the Barangay Chairman.
 If residing in a building/condominium/apartment/boarding house/rented residence: submit a photo of the whole building/area and whole
view of the room you are staying.
□ Photocopy of electric bill for the last 3 months
 If not applicable: Submit a letter, addressed to the Scholarship Committee, indicating reasons for non-paying.
□ Two (2) Recommendation Forms in SEALED envelopes (Form at Page 7) (Unsealed and tampered envelopes will not be considered):
 For New High School Graduates: a) High School Principal / Prefect of Discipline AND b) Guidance Director / Counselor or Class Adviser
 For Transfer Students: a) Director of Student Affairs AND b) Guidance Director/Counselor or former Professor from last college attended
 For Current Ateneo Students: a) Director of Student Affairs AND b) Guidance Director/Counselor
□ For applicants who belong to a tribal community / indigenous peoples, please get an additional RECOMMENDATION / ENDORSEMENT
LETTER from Ms. Perpy Tio.
Office Address: Basement Floor, Finster Building

STEP 2
You will be scheduled for an interview by a member of the Scholarship Committee or an assigned professor once your application materials are
verified and declared complete.

STEP 3
On the day of the interview, you will be required to write an essay on a topic specified by the Scholarship Committee. Kindly bring necessary writing
materials. PLEASE BE REMINDED THAT NON-APPEARANCE DURING THE SCHEDULED INTERVIEW MEANS CANCELLATION OF YOUR APPLICATION.

---------------------------------------------------------------------------------------------------------------------------------
-----------------
(Kindly return this portion to the applicant)

NAME of APPLICANT (Last Name, First Names, Middle Name)

DATE and TIME SUBMITTED RECEIVED BY

Scholarship Interview Details

DATE TIME ROOM

IMPORTANT: Credentials and documents filed in support of this application become the property of Ateneo de Davao University and will not be returned to the applicant.

Page 1 of
7 FORM 230-SCH [REV 2-2015]
PREVIOUS EDITION OBSOLETE
 PHOTO
Ateneo de Davao University 1” x 1” or 2” x 2”
APPLICATION FOR FINANCIAL AID Glue photo here.
Do not staple.
Please type or print your answers in the space provided. It must be answered completely. THIS FORM CAN BE PHOTOCOPIED.
Please write the initials NA for questions that are not applicable.

APPLYING FOR
 WORKING STUDENT  REGULAR FINANCIAL AID
 First Semester  Second Semester  School Year:

Track Strand

Name of Senior High School Address of Senior High School

Preferred Degree/Program (First Choice) Preferred Degree/Program (Second Choice) Preferred Degree/Program (Third Choice)

Did you apply to government institutions that offers financial If yes, please check the institution:
assistance or grants? □ Yes □ No □ CHED □ DOST □ STEP □ GSIS
□ Others
Did you apply to other external foundation / organization that offers If yes, please indicate the foundation(s) or organization(s):
educational scholarship? □ Yes □ No

PERSONAL INFORMATION
1. Last Name 2. First and Middle Names Nickname

3. House No. Street Subdivision/Village Barangay

Town / City Province ZIP 4. Home Tel No.

5. Mobile Phone 6. Email Address

7. If applicant is from the province, please indicate the address and where he/she is staying in Davao City during his/her studies at Ateneo:
□ Boarding House □ With a Relative □ Others, please specify:
Address:

8. Religion 9. Citizenship 10. Sex 11. Civil Status

□ Male □ Female □ Single □ Married
12. Date of Birth (MM/DD/YYYY) 13. Place of Birth 14. Do you belong to a Tribal Community? □ Yes □ No

15. What Tribe?

16. Name and Address of Grade School 17. Name and Address of High School

18. Awards Received in High School 19. Name & Address of College or University (If Transfer Student)

20. Skills 21. Any Work Experience

DATA ON FAMILY
22. If parents are not married, please check which is applicable: □ Single Parent □ Separated □ Widowed/Widower
23. Father’s Complete Name Birthdate (MM/DD/YYYY) If Deceased, When?

Occupation (If self-employed, describe nature of work) Position Name of Company / Employer

Annual Income (check if it matches with Income Documents submitted) Any commissions, fees, allowances or other benefits No. of years in the company?
received? (example: Company laptop)
If unemployed, please state when last employed and reason for unemployment now

24. Mother’s Complete Name Birthdate (MM/DD/YYYY) If Deceased, When?

Occupation (If self-employed, describe nature of work) Position Name of Company / Employer

Annual Income (check if it matches with Income Documents submitted) Any commissions, fees, allowances or other benefits No. of years in the company?
received? (example: Company laptop)

If unemployed, please state when last employed and reason for unemployment now

25. Siblings still in school (EXCLUDING APPLICANT) or not yet studying:

Name Age Civil Status Grade/Year School Yearly Tuition & Fees Amount Covered by Amount Covered
Scholarship (if any) by Parents
1
2
3
4
26. Siblings who are no longer in school / employed: (Make sure Income Documents of each employed sibling are present)
Name Age Civil Status Still Residing Provides Financial Where Employed? Position Annual Gross
(Include no. of with You? Assistance? (If unemployed, state Income
dependents?) reason.)
1
2
3
4
27. Other adult persons (EXCLUDING PARENTS AND SIBLINGS) living with the family:
Name Relationship Civil Status Financially Supporting the How much, if
(include no. of Household? applicable?
dependents living with
you)
1
2
3
4

PERSONAL EXPENSES and FAMILY FINANCIAL INFORMATION

28. How much is your daily 29. Are you satisfied with your 30. Mode of Transportation to School
allowance? allowance? □ Yes □No □ Public Transport □Private Car □Others:
31. Daily Food Expenses 32. Daily Food Intake 33. Daily Transportation 34. Other Personal Expenses
□ Adequate □ Inadequate Expenses □ Internet: P □ Project: P □ Others: P
35. Do you have personal savings for the past three (3) months? □ Yes □ No If yes, how much have you saved? P
36. Does your family have other sources of 37. What kind? 38. Income per Month
income? □ Yes □ No
39. Assets Owned by the Family
□ HOUSE If answer is NO, is your house? Who is the owner? Monthly Rent
(including the one you are living □ Rented
in) If answer is NO, is your house? Who is owner? Relationship to the Owner
How many? □ Owned by Somebody Else
□ LOT (including the one your house is located) If answer is NO, is your lot? Who is the owner? Monthly Rent
How many? □ Rented
If answer is NO, is your lot? Who is the owner? Relationship to the Owner
How big (in sq meters)? □ Owned by Somebody Else
□ CAR How many? □ JEEP How many? □ MOTORCYCLE How many? □ HEAVY EQUIPMENT How many?
40. Other Properties Owned
Description Uses Size / How Many? Acquired When If any, Monthly Income?
1
2
41. Household Appliances Owned by the Family
Quantity Acquired When? Acquisition Cost Monthly Payment Remarks
1 Telephone
2 Television Set(s)
3 VCD / DVD Player(s)
4 Component System / Videoke
5 Airconditioner(s)
6 Desktop Computer
7 Laptop Computer
8 Refrigerator / Freezer
9 Gas Stove / Oven
10 Washing Machine / Dryer

OTHER INFORMATION
42. Have you had financial difficulty for the last three months? □ Yes □ No
43. What were the reasons of your financial problem? (You may check as If not indicated, please write here other reasons:
many)
□ School Expenses
□ Insufficient Parents’ Income
□ Problem in Budget Management
□ Parents’ Unstable Income

44. How does your family cope with the financial difficulties? (You If not indicated, please write here other ways to cope with the difficulty:
may check as many)
□ Borrow money from friends/relatives
□ Loan from banks/cooperatives/financial institutions
□ Give promissory notes
□ Pawn or Sell valuables
45. Did the applicant enjoy any form of financial aid in high school? If yes, what kind/how much?
□ Yes □ No
46. What is your perception of your family’s economic status? □ Lower Class □ Middle Class □ Upper Class
47. Are you willing to render community service as counterpart of the grant that may be given to you? □ Yes □ No
48. Preferred Course (First Choice) Preferred Course (Second Choice) Preferred Course (Third Choice)

49. List down two (2) persons who know you well and can make an objective assessment of your abilities and skills for undergraduate work:
Name Position Institution Contact Number & Email Address
1
2

APPLICANT’S AFFIDAVIT OF AGREEMENT

1. I certify that I have read and understood all the questions set forth in this financial assistance application and the answers I have furnished
on this form are true and correct to the best of my knowledge and belief;

2. I also hereby authorize the University to verify the same through an official inquiry, if needed. I understand that any false or
misleading statement may result in the refusal of admission into the University and/or non-qualification for a grant;

3. I understand that possession of an educational pre-need plan or other scholarship grants outside Ateneo automatically voids or affect
the outcome of this application;

4. I understand that I have the obligation to submit all the required documents by the University and that failure on my part to comply may
mean the denial of my application;

5. I also understand that the grant applied for is a matter of privilege, and thus not a demandable right;

6. I understand that the results of the application and minutes of the deliberations of the Scholarship Committee are confidential thus I
have no right to demand for any information relating thereto;

7. I hereby waive any and all actions against the Ateneo de Davao University, or any of its officers and administrators, in the event of
the denial of my application.

Applicant’s Signature over Printed Name Date Signed (MM-DD-YY)

FATHER’S SIGNATURE over Printed Name MOTHER’S SIGNATURE over Printed Name

This form has been published by the College Scholarship Committee © 2012
Ateneo de Davao University
E. Jacinto Street, 8016 Davao City Philippines
Tel (63)(82) 221.2411 local 8303 / 8374 * Fax (63)(82) 226-4116 * Email: admissions@addu.edu.ph * www.addu.edu.ph

The information you provide on this form is collected under the authority of the University Scholarship Committee Guidelines to determine if the applicant may be qualified to be
granted financial assistance. It will be stored in the Scholarship Information Bank Records and Case File. It is protected and accessible under the applicable privacy laws and the
access to information laws of the Republic of the Philippines.
51. Please make a sketch or directional map to your home in the space provided below. Indicate landmarks and signs to help the Scholarship
Committee locate your house in case of home visit and inspection.
52. Please paste PHOTOS of permanent residence here: FRONT VIEW OF THE WHOLE HOUSE and KITCHEN. If residing in a
building/condominium/apartment/boarding house/rented residence, submit a photo of the whole building/area and whole view of the room you are
staying.
COMPLETE ADDRESS:

CERTIFICATION
This is to certify that the applicant and his/her family are permanent residents of the above-mentioned address.
Further, in my capacity as Punong Barangay, I certify that the photos inserted here are truly parts of their house located at the aforementioned
address.
This is issued upon the request of the applicant for COMPLIANCE OF A SCHOLARSHIP REQUIREMENT only.

Issued on th day of , in the year of at .

Punong Barangay
(Dry Seal, if applicable)
 Ateneo de Davao University
RECOMMENDATION FORM
For Student Financial Assistance Application
THIS FORM CAN BE PHOTOCOPIED.

NAME of APPLICANT First and Middle Names DEGREE SOUGHT

Last Name □ AB
PLAYDA VINCE □ BS
The applicant must not write below this line.
TO THE RECOMMENDING PERSON: Please type or print your assessment and recommendation either on the back of this sheet or on your own
letterhead. When you have completed your recommendation, enclose it together with this form in an envelope. Seal it, sign it across the seal and
return it to the applicant. Do not allow the applicant to see the content of your assessment and recommendation.

Please write candidly as possible about the applicant’s qualifications and potentials to carry out undergraduate studies in the field specified. Assess
as well the candidate’s promise of professional success. In evaluating such qualities as the applicant’s motivation, intellect, creativity, discipline and
maturity, please discuss both strengths and weakness. If you can recall specific instances in which these qualities were revealed to you, this would
be most helpful.
1. How long have you know the applicant? 2. You have known the applicant as your
1 YEAR □ Student □Counsellee □ Constituent □ Others:
2. If the applicant is enrolled in any of your classes, training, seminar, please indicate what subjects or training and the academic mark or evaluation:
LEADERSHIP DEVELOPMENT PROGRAM : 96%

3. Please describe the applicant’s potential as an Ateneo scholar.

Vince is a model Ateneo student. He embodies the six Cs that the Ateneo de Davao Senior High School teaches its students. He is a born
leader. He leads his class in the many extra-curricular activities that the school provides. He is also very passionate to the advocacies he is
involved with. He is a great addition and asset as an Ateneo scholar especially as a future leader in Mindanao as stipulated in our Mission and
Vision.
5. Was the applicant sanctioned by authorities due to If Yes, please indicate offense.
behavioral misdemeanor or offense? □ Yes □ No □ I
do not know.
6. Was the student put under academic probation due to deficiency in If Yes, please indicate deficiency.
academic performance? □ Yes □ No □ I do not know.

7. Indicate additional information that may help the Scholarship Committee in deliberating the application of the student (v.g. strength, areas for
improvement, weakness, skills, attitudes towards service, etc.)

Vince needs the opportunity to showcase his talents and skills as an Atenean scholar.

8. Rate the applicant. Please check the appropriate box. [5 = Excellent, 4 = Very Good, 3 = Good, 2 = Fair, 1 = Poor, 0 = No Chance to Observe]
5 4 3 2 1 0
Intellectual Capacity
Desire to achieve
Potential to succeed in major field
Emotional Maturity
Confidence
Motivation to work and study
Initiative
Resourcefulness
Ability to get things done
Responsibility
Ability to work with others
Leadership Qualities
Oral expression skills
Flexibility
Sense of humor
Writing ability
9. Based on the information above, indicate your recommendation by ticking one of the boxes.
□ I highly recommend the applicant (a rare find). □ I recommend the applicant with reservations.
□ I recommend the applicant. □ I do not recommend the applicant.
10. Name of the Recommending Person Signature
RAPHAEL GERARD G. GRADO

Position Telephone Number Email Address

LDP ADVISER/THEOLOGY TEACHER 09429752396 rgggrado@addu.edu.ph