2019 DOST-SEI Science and Technology Undergraduate Scholarships Application Form - Deadline for Filing of Application - August 31, 2018

Sep 22, 2026

Uploaded by Kurz

2019 DOST-SEI Science and Technology Undergraduate Scholarships Application Form collects applicant personal data, family data, and scholarship intention selections. The form requests information including birth details, contact and citizenship, school type and fees, household member profile, and 2017 gross income indicators. It includes instructions for answering and correcting entries, requirements for original signatures and attached photos, assessment options for RA 7687 and DOST-SEI Merit Scholarship, and examination schedule details.

LanguageEnglish

CategoryExam

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Form A - Personal Information

Personal Data

Family Data

Form B - Household Info

Household Profile

Scholarship Intentions Data

| TO BE FILLED-OUT BY DOST/SEI STAFF ONLY | | --- | | APPLN.NO.
TCC
2017 Total Annual Family Gross Income:
(Taxable &Non-taxable) P_____
Avg.Electricity Consumption
___ kwh
for 3 months:
Annual HS Net Tuition &
P______
Other School Fees:
Ownership of Vehicle:_____
Scholarship Program Assessment:
RA 7687
MERIT P200.00/O.R.No.
Assessed by:
Printed Name/Signature
DOST RO.No._
SEI | Republic of the PhilippinesDepartment of Science and TechnologySCIENCE EDUCATION INSTITUTEP.O.Box 18 Taguig Post Office # 2019 DOST-SEISCIENCE AND TECHNOLOGYUNDERGRADUATE SCHOLARSHIPSAPPLICATION FORM Deadline for Filing of Application: August 31,2018Schedule of ExaminationOctober 21,2018 | FORM A-PERSONAL INFORMATION | | | | | | | --- | --- | --- | --- | --- | --- | | Instruction:Write clearly in the box provided or check the box for the apprpriate answer.Avoid erasures.For any erasure,the applicant should countersign the
item corrected along the page margin.PLEASE ANSWER ALL ITEMS. | | | | | | | I.PERSONAL DATA | | | | | | | Name of Applicant (Last Name,First Name,Middle Name,Sufix Name): | | | | | | | Date of Birth(MM/DD/YYYY):
/
/ | Place of Birth: | Number of Children in the
Family: | | Birth Order of Applicant(1child,2”child,etc.): | | | Sex:
□Male □Female | Mobile Phone No.: | Email address: | | Citizenship: | | | Permanent Address (House/Unit No.,Street,Lot/BIk,VIllage/Barangay): | | | | Do you have dual
citizenship?
□No
□Yes | If yes,please specify: | | City/Municipality: | Province: | Zipcode: | District: | Have you been issued a
passport?
□No
□Yes | If yes,write the Passport No.: | | Type of School:
□Regular Public HS
□Science HS □Private HS □University/College-based Senior HS | | | | Senior High School Strand:
□STEM □NON-STEM | | | Name of School: | | | | Tuition and Other Schoo Fees Paid in a Private
High School:
P | | | Address of School: | | | | Please attach assessment form or statement of account provided by the
school.If with scholarship,submit a certification from school or foundation
indicating the name of scholarship and amount of grant. | | | II.FAMILY DATA | | | | | --- | --- | --- | --- | | | Father | Mother | Legal Guardian
(To be accomplished ONLY by those
whose parents are deceased,working
abroad,etc;should submit affidavit of
guardianship) | | Name | | | | | Highest Educational Attainment | | | | | Occupation(pls.specify) | | | | | Name of Employer | | | | | Employer Address | | | | | 2017 Annual Gross Income
(in pesos;taxable and non-taxable) | | | | | If self-employed,declare 2017
Annual Gross Income | | | | | □No
Is your household included in the DSWD Listahanan 2.0?□Yes
(If yes,please provide clear photocopy of your DSWD ID) | | | | | Is your family a beneficiary of the DSWD's Pantawid Pamilyang Pilipino Program(4Ps)?□Yes □No
(If yes,please provide clear photocopy of your family's 4Ps ID.) | | | | | III.SCHOLARSHIP INTENTIONS DATA | | | --- | --- | | Check appropriate box for scholarship program applied for: | | | □ | RA 7687 SCIENCE AND TECHNOLOGY SCHOLARSHIP
For applicant who belongs to a family whose socio-economic status does not exceed the set values of ALL the identified indicators as
approved by the Advisory Committee on S&T Scholarships. | | □ | DOST-SEI MERIT SCHOLARSHIP
For an applicant who belongs to a family whose socio-economic status exceeds the set values of any of the identified indicators.
Applicant must pay a non-refundable test fee of P200.00. | STSD-101.1Rev.0/11-09-15NOT FOR SALECAN BE REPRODUCEDALL ENTRIES/SIGNATURE INTHIS FORM MUST BE ORIGINAL.Attach recent1"×1"photo hereOnce of

FAQs

What deadline and examination schedule are listed for the 2019 application?

The form states the deadline for filing applications is August 31, 2018, with the examination schedule dated October 21, 2018.

Which scholarship programs can an applicant choose in the form?

Applicants can check RA 7687 Science and Technology Scholarship or the DOST-SEI Merit Scholarship, each with different eligibility and requirements.

What additional documents and photos are required with the application?

The form requires original entries and signatures, attaching a recent 1×1 photo (and another copy for the test permit), and submitting the relevant assessment or statement of account and scholarship certification documents if applicable.

Sep 22, 2026

Uploaded by Kurz