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    Application Form Start-Up (YFC)

    Uploaded by

    grendez2023
    This is the format used for the application in Young Farmers' Challenge

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Application Form Start-Up (YFC)

    Uploaded by

    grendez2023
    1 views3 pages
    This is the format used for the application in Young Farmers' Challenge

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    This is the format used for the application in Young Farmers' Challenge

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1 views3 pages

    Application Form Start-Up (YFC)

    Uploaded by

    grendez2023
    This is the format used for the application in Young Farmers' Challenge

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    YOUNG FARMERS CHALLENGE START-UP

    2x2 PICTURE
    APPLICATION FORM
    ------------------------------------------------------------------------------------
    Part I. Personal Information

    Surname First Name

    ______________________________________ ____________________ Male Female


    Middle Name Extension Name

    Permanent Address:

    ________________________ ___________________________ __________________


    House/Lot/Bldg. No/Purok Street/Sitio/Subdv. Barangay

    ________________________ ___________________________ _______________________


    Municipality/City Province Region

    Mobile Number: ________________________ Facebook Link: _____________________________

    Email Address: _______________________ Highest Formal Education:

    Date of Birth: _____/______/______ Pre-School Junior HS Vocational


    M D Y Elementary Senior HS Post-Graduate
    High School (non-k12) College None
    Place of Birth: _________________________
    ______________________________________

    If you are currently enrolled in college or have recently


    graduated, please specify your
    course:___________________________________________

    Religion: _____________________________ Person with Disability (PWD)? Yes No

    Name of Spouse Member of an Indigenous Group? Yes No


    If Married: ___________________________ If yes, specify: ________________

    Mother’s
    Maiden Name: ______________________ With Government Issued ID? Yes No
    If yes, specify ID
    Type:____________
    ID No.: _____________
    Person to Notify in case of
    emergency: __________________ Member of any Farmers Yes No
    Association/
    Contact No: __________________ Cooperative/Organization?
    If yes, specify: ______________________________

    Currently Employed? Yes No

    If yes, Name of Employer ______________________


    Address: ______________________________
    Office Contact No: ______________________

    Have a family relative working in the Department of Agriculture, its bureaus, or attached agencies and Provincial,
    Municipal, and City Agricultural Offices within the 4th civil degree of consanguinity or affinity?
    Yes No
    -------------------------------------------------------------------------------------------
    --------------------------Part II. Proposed Enterprise Information
    Young Farmers Challenge Entry: Individual Group

    Enterprise Category: Production Digital Agriculture


    Processing

    If group managed enterprise, state the names and address of the members:

    Name: _______________________ Name: _______________________


    Address: _____________________ Address: _____________________

    Name: _______________________ Name: _______________________


    Address: _____________________ Address: _____________________

    General Business Information

    ● Proposed Enterprise Name: ______________________________________


    ● Proposed Business Address: _____________________________________
    ● Proposed Head of Enterprise
    in case group-managed: ___________________________________

    Brief Description of the proposed agri-fishery enterprise (not more than 250 words)

    *I hereby declare that all information indicated above are true and correct, and that they may be used by Department of Agriculture
    for the purpose of my application for the YFC Start-Up program.

    _____________________________
    Signature over printed name
    YFC START-UP APPLICANT

    Date: _______________________

    Data Privacy Statement

    By filling-out this form you agree with Data Privacy you agree with the Data Privacy of the Department of Agriculture and the
    National Privacy Commission. Both personal and non-personal information may be collected using this form. Rest assured that
    data shall be kept safe and secure, and will not be shared with anyone except for designated personnel who will process the
    needed information only for facilitating this competition.

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