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NO.\u003Cbr>-\u003Cbr>\u003Cbr> |  |  |\n| | 2019 Total Annual Family Gross Income:\u003Cbr>(Taxable & Non-taxable) ₱   Ownership of Vehicle:   Beneficiary of 4Ps (Y/N):   Scholarship Program Assessment: | |\n|  | \u003Cbr>RA 7687 MERIT |  |\n|  | Assessed by: _____________________________   Printed Name / Signature\u003Cbr>  SEI   DOST RO. No.   |  |\n\nRepublic of the Philippines Department of Science and Technology SCIENCE EDUCATION INSTITUTE  \nP.O. Box 18 Taguig Post Office  \n2021 DOST-SEI SCIENCE AND TECHNOLOGY UNDERGRADUATE SCHOLARSHIPS APPLICATION FORM  \nDeadline for Filing of Application: August 28, 2020 Schedule of Examination : October 25, 2020  \n| QUESTIONNAIRE |  |  |\n| --- | --- | --- |\n| Instruction: Please READ CAREFULLY and ANSWER TRUTHFULLY the following questions by shading the circle corresponding to your answer.\u003Cbr>(PAKIBASA NG MABUTI at SAGUTIN NG BUONG KATOTOHANAN ang mga sumusunod na tanong sa pamamagitan ng pagmarka sa bilog ng iyong sagot.) |  |  |\n| Yes | No |  |\n| 􀁻 | 􀁻 | 1. Are you a natural born Filipino citizen?\u003Cbr>(Ikaw ba ay isang natural-born na Pilipino?) |\n| 􀁻 | 􀁻 | 2. Are you a resident of your municipality for 4 years or more?\u003Cbr>(Ikaw ba ay residente ng iyong munisipalidad ng 4 na taon o higit pa?) |\n| 􀁻 | 􀁻 | 3. Is your family a recipient of the DSWD’s Pantawid Pamilyang Pilipino Program (4Ps)?\u003Cbr>(Ang pamilya mo ba ay tumatanggap ng benepisyo mula sa DSWD’s Pantawid Pamilyang Pilipino Programs (4Ps)?) |\n| 􀁻 | 􀁻 | 4. Are you in STEM Strand?\u003Cbr>(Ikaw ba ay nasa STEM Strand?) |\n| 􀁻 | 􀁻 | 4.1 (Answer this question only if your answer in question 4 is NO)\u003Cbr>Are you in a Non-STEM Strand (i.e. , HUMMS, ABM, GAS, TVL, etc.)\u003Cbr>(Ikaw ba ay nasa Non-STEM Strand (i.e., HUMMS, ABM, GAS, TVL, etc.)? |\n| 􀁻 | 􀁻 | 4.1.1 (Answer this question only if your answer in question 4.1 is YES)\u003Cbr>Based on your Grade 11 standing, are you a member of the upper 5% of the graduating class?(Base sa iyong Grade 11 standing, ikaw ba ay kasama sa upper 5% ng graduating class?) |\n| 􀁻 | 􀁻 | 4.1.2 (Answer this question only if your answer in question 4.1 is NO)\u003Cbr>Are you homeschooled/a graduate before the K-12 program?\u003Cbr>(Ikaw ba ay homeschooled/nakatapos ng high school bago ang K-12 program?) |\n| 􀁻 | 􀁻 | 5. Do you have a pending application for immigration to the USA or any other country?(Ikaw ba ay may nakabinbin na aplikasyon para sa immigration sa USA o sa ibang bansa?) |\n| 􀁻 | 􀁻 | 6. Have you been subjected to any disciplinary action?\u003Cbr>(Ikaw ba ay sumailalim na sa kahit anong disciplinary action?) |\n| 􀁻 | 􀁻 | 7. Can you take the DOST-SEI examination without any assistance during the exam?\u003Cbr>(Kaya mo bang kumuha ng DOST-SEI examination nang walang tumutulong habang sumasagot sa exam?) |\n| 􀁻 | 􀁻 | 8. Have you taken any previous DOST-SEI Examination?\u003Cbr>(Nakakuha ka na ba ng anumang nakaraang pagsusulit/exam ng DOST-SEI?) |\n| 􀁻 | 􀁻 | 8.1. (Answer this question only if your answer in question 8 is YES)\u003Cbr>Were you able to qualify for the scholarship?\u003Cbr>(Ikaw ba ay nag-qualify sa scholarship?) |\n| 􀁻 | 􀁻 | 8.1.1 (Answer this question only if your answer in question 8.1 is YES)\u003Cbr>Did you avail the scholarship?\u003Cbr>(Tinanggap mo ba ang scholarship?) |\n| 􀁻 | 􀁻 | 9. Have you earned any collegiate or vocational units?\u003Cbr>(Ikaw ba ay nakakuha na ng collegiate or vocational units?) |\n\n\n| FORM A – PERSONAL INFORMATION |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| Instruction: Write clearly in CAPITAL LETTERS your personal information in the box provided or check the box for the appropriate answer. Avoid erasures. For any erasure, the applicant should countersign the item corrected along the page margin. PLEASE ANSWER ALL ITEMS. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| I. PERSONAL DATA |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| Name of ","cbCaii1yCwpSDEYf","https://ap.wps.com/l/cbCaii1yCwpSDEYf","pdf",714754,"English","# Questionnaire\n## Eligibility and background questions\n# Form A – Personal Information\n## Personal data\n## Family data","[{\"question\":\"What eligibility areas are covered in the questionnaire?\",\"answer\":\"The questionnaire checks citizenship and residency, whether the applicant’s family is a 4Ps beneficiary, STEM track status, pending immigration applications, disciplinary actions, and whether the applicant can take the DOST-SEI exam without assistance.\"},{\"question\":\"Which follow-up questions appear if the applicant is not in a STEM strand?\",\"answer\":\"If the applicant answers NO to being in a STEM strand, additional items ask whether they are in a Non-STEM strand and then request details based on further conditions related to Grade 11 standing or homeschooling/previous completion before K-12.\"},{\"question\":\"What personal information and family details must be provided?\",\"answer\":\"The form requests applicant personal data such as name, birth details, contact info, citizenship/dual citizenship, school type and strand, plus family data including parent or legal guardian information and 2019 annual gross income (taxable and non-taxable).\"}]","2021 DOST-SEI Science and Technology Undergraduate Scholarships Application Form - Questionnaire and Personal Information | PDF",1790044821]