THIS BOX MUST BE FILLED BY STFAP PERSONNEL ONLY

This box must be filled by STFAP personnel only

STUDENT NAME: APPLICATION FORM NO.:
STUDENT NO.: [ ][ ]-[ ][ ][ ][ ][ ] CAMPUS:

University of the Philippines

APPLICATION FOR FINANCIAL ASSISTANCE UNDER THE
ISKOLAR NG BAYAN
(STFAP)*
To qualify for financial assistance, the student must satisfy the following:

1. The student must be a Filipino citizen.

2. He must be a bonafide undergraduate student. Except for Law and Medicine, the applicant must not have a
bachelor's degree.

3. For an old or continuing U.P. student, who has been classified by the University as belonging to Brackets 1-4, he
must meet academic requirements set by the University for STFAP grantees to receive living and book subsidies.

4. For an incoming freshman or new student, he must have a UP Admission slip/notice.

5. The student must never have been adjudged guilty of any offense which carries a penalty of more than thirty (30) days
suspension.

6. He must be in need of financial assistance as determined by the University.

IMPORTANT NOTICE
If student is an incoming freshman, the initial grant shall be for two (2) semesters. All other grants and their
renewals, shall be for one (1) semester only.
The University reserves the right to determine whether the student deserves financial assistance, and the kind
and amount of assistance.
STFAP privileges will be withdrawn from a student who withholds and/or falsifies information, without
prejudice to other penalties that may be imposed by the University. In this connection, please be informed
that some students have been expelled from the University for withholding and/or falsifying information in
their STFAP application.
All information supplied by the student will be treated with strict confidentiality and will be for internal use
only by the University.

DEADLINE FOR SUBMISSION OF APPLICATION FORMS

* Old students:

* Incoming freshmen:

* Transfer students from non-UP schools:

* Socialized Tuition and Financial Assistance Program

1
 APPLICATION FORM NO. _________
University of the Philippines
ISKOLAR NG BAYAN PROGRAM
(STFAP)

APPLICATION FORM FOR FINANCIAL ASSISTANCE

To be filled out by the student and parent / legal guardian / spouse if applicant is married. Avoid erasures. For any erasure, the applicant
should countersign the item corrected along the page margin. Answer all questions. When the answer is none, write 0. When the question
is not applicable, write NA. Do not leave blanks.

Part 1. Checklist of Required Documents/Materials*

NOTE: In connection with this application, be sure to submit (where applicable) the following documents/materials. Non-submission of
applicable documents/materials may be considered withholding of information.

1.1 One(1) copy of 2"x2" (passport size) picture. Print name and U.P. student number at the back of the picture.

1.2 Income Tax Returns (including attached BIR Form W-2, balance sheets and income statements), of parents/legal guardian/spouse. For those
who are tax exempt, submit a certification of exemption from BIR stating the annual gross income. If parent/legal guardian/spouse is retired,
submit retirement and/or pension voucher.

1.2.1 For first-time applicants

Income tax returns (including all attachments) of parents/legal guardian/spouse for the last 3 years.

1.2.2 For old applicants

Income tax returns (including all attachments) of parents/ legal guardian/spouse for the current year only.

1.3 Income Tax Returns of other gainfully employed members of the household for the past year.
Note: Household means all persons living under the same roof and/or sharing food and expenses.

1.4 Affidavit of support from legal guardian, if parents are deceased or incapacitated.

1.5 Personal Statement of Assets and Liabilities of parent/legal guardian/spouse. Use page 15 of this form.

1.5.1 Bank, housing, car or commercial loan and mortgage documents.

1.5.2 Affidavit concerning personal loan if value of loan declared on page 15 exceeds P10,000.

1.6 Latest Tax Declarations of all real properties (required of everybody who has real property)

1.7 Last month's electric bill.

1.8 Last month's water bill.

1.9 Business / DTI permit (if applicable).

THIS BOX IS FOR USE OF UP STFAP
1.10 Marriage certificate if applicant is married. PERSONNEL ONLY
Form completely filled out?
FOR INCOMING STUDENTS/FIRST-TIME APPLICANTS 1 Yes
2 No Lacks Nos. _____________
Items 1.1 to 1.10 plus: Notarized? Office code :
1 Yes 1 Yes
1. U.P. admission slip. 2 No 2 No

2. Birth certificate or affidavit of birth.

* Photocopy is required. When the student submits the documents,

the originals must be presented for authentication.

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 STFAP APPLICATION FORM NO __________.
_______ SEMESTER 19________ - 19________
Part 2. Application Form
NOTE: Please print all entries legibly. If boxes are provided, enter only one alphanumeric
character per box. Encircle appropriate code for multiple choice items.
2" x 2"
2.0 Student Data Picture

Print name and student

2.1 U.P. Student No.: [ ][ ]-[ ][ ][ ][ ][ ]
number on picture and
staple here
2.2 Student's Name:
Family Name: _____________________________________________
First Name: _______________________________________________
Middle Name: _____________________________________________
Maiden Name (If married woman): ____________________________

2.3 Student's Address: 1 Home 2 Dorm 3 Boarding House 4 Others

Street Address: _________________________________________

Barangay: _____________________________________________
City/Town: ____________________________________________
Province: ______________________________________________ Zip Code: _____________

2.4 Student's Telephone Number (while at U.P.) :____________________

2.5 Parent's Address:

Street Address: _________________________________________
Barangay: _____________________________________________
City/Town: ____________________________________________
Province: ______________________________________________ Zip Code: _____________

2.6 Parent's Telephone Number: _______________________________________

2.7 Student's Permanent Address (if other than address in 2.3 or 2.5):
Street Address: _________________________________________
Barangay: _____________________________________________
City/Town: ____________________________________________
Province: ______________________________________________ Zip Code: _____________

Distance (kms.) from residence to campus: ______________________

Cost of one-way transport (cheapest rate) P__________________________________________
Specify: 1 Boat 2 Bus 3 Plane

2.8 Date of Birth: [ ][ ] [ ][ ] [ ][ ]

Month Day Year

2.9 Sex (encircle appropriate code): 1 Male 2 Female

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2.10 Civil Status (encircle appropriate code):
1 Single 2 Married 3 Separated/Divorced 4 Widow/Widower 5 Others
If married: 1 living with parents/in-laws/relatives
2 living independently

2.11 Do you have a brother / sister / stepbrother / stepsister / spouse enrolled in an undergraduate college course anywhere in the U.P.
System? 1 Yes 2 No

If yes, supply the necessary information in the box below.

Applying for STFAP this

Civil
Name Campus College Student No. semester?
Status
Yes No

2.12 Type of financial assistance applied for (encircle only one numeric code below)

Type of financial assistance

STFAP BRACKET

}
100% waiver of tuition, miscellaneous and 1
laboratory fees, plus corresponding living, 2
lodging, transportation and book allowances 3
(subsidies) 4

100% tuition subsidy only 5

75% tuition subsidy only 6
50% tuition subsidy only 7
25% tuition subsidy only 8

2.13 High School Data:

Name of High School: _____________________________________________
Street Address: ___________________________________________________
City/Town: ______________________________________________________
Province: _______________________________________________________

Type of High School (encircle appropriate code):

4 Public barrio / barangay 7 Private sectarian
1 Public general
5 U.P.-administered 8 Private non-sectarian
2 Public special (e.g., science h.s.)
6 Other state university h.s.
3 Public vocational

Tuition and other fees paid in fourth year high school P __________ / year
Were you on scholarship in high school ? 1 Yes 2 No

2.14 Are you a transferee from a non UP school ? 1 Yes 2 No

If yes, tuition and other fees paid last semester in previous college P __________ / semester
Were you on scholarship in previous college? 1 Yes 2 No

4
2.15 College Data (encircle appropriate code):
Campus:
1 Diliman 3 Los Banos 5 San Fernando 7 Tacloban/Palo
2 Manila 4 Baguio 6 Cebu 8 Iloilo/Miagao
9 Mindanao

College : Year Level :

Degree :

Type of Student:

1 Freshman

2 Transferee from non-UP school

AY Bracket AY Bracket
1994-95 __________ 1997-98 __________
3 Old Student (Old STFAP applicant) 1995-96 __________ 1998-99 __________
1996-97 __________ 1999-00 __________
4 Old Student (New STFAP applicant)

Have you been adjudged guilty of an offense and penalized for 30 days or less anywhere in the U.P. system?
1 Yes 2 No If yes, how many days? ______
Is there a pending case against you in the Student Disciplinary Tribunal or college investigating committee? 1 Yes 2 No
If yes, what? __________________________________________________________________

Have you filed an appeal for STFAP rebracketting in previous years ? 1 Yes 2 No
Have you been visited by an STFAP Home Visit Team? 1 Yes 2 No

2.16 Do you already have a bachelor's degree? 1 Yes 2 No

If yes, what degree did you finish ? ___________________

Year graduated ________
Name of school: __________________________________
Location of school: ________________________________

2.17 Are you staying in a boarding house or dormitory? 1 Yes 2 No

If yes, are you staying in a U.P. dorm? 1 Yes 2 No

Monthly board P __________________
Monthly lodging P _________________

2.18 Daily mode of transport to and from school campus (encircle codes):

1 Family/own vehicle
2 Carpool
3 Motorcycle
4 Public transport
5 Bicycle/walk
If public transport, cost per day P ________

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2.19 Employment Status of Student (encircle codes):

1 Full-time employment

2 Part-time employment

3 Not-employed

If you worked last year, state gross income ________

Name of company: __________________________
Address: ________________________________ Tel. No. ___________
Is this a family business or family-owned corporation? 1 Yes 2 No

2.20 Who will finance schooling (encircle all applicable codes):

1 Parents

2 Self (working student)

3 Scholarship (other than STFAP)

Name of scholarship: ________________________________
Total amount of support per semester: P ____________ (including tuition, stipends, others)

4 Educational Plans (e.g. Preneed educational plan, CAP)

Name of plan: __________________________________________
Total amount of support per semester: P _____________ (including tuition, stipends, others)

5 Others (e.g. spouse, brothers, uncle)

Indicate estimated amount of contribution per semester (5 months): P _______

2.21 Membership of parents or spouse in (encircle all applicable numeric codes):

0 None

1 Sports and country club (e.g., Makati Sports Club, Wack Wack Golf Club)

2 Service organization (e.g. Lions, Rotary)

3 Professional association (e.g. Integrated Bar)

4 Business organization (e.g. PCCI, Chamber of Commerce)

5 Others, please specify ________________

2.22 Do you have a passport? 1 Yes 2 No

If yes, passport # ______________

Have you ever travelled outside the Philippines within the past five years? 1 Yes 2 No

If yes, who financed the trip? 1 Family 2 Others

6
3.0 FAMILY DATA

3.1 Parents/Legal Guardian or Spouse, if applicant is married. Are your parents separated/divorced ? 1 Yes 2 No
Living
N ame of Family Highest degree or School attended / Present job designation (O fficial Job Previous Year's Still Alive
N ame of employer Income Taxes Paid Abroad?
Member year level reached graduated Title) Gross Income
Yes No Yes N o

Father / Stepfather

Mother /
Stepmother

Spouse

Legal Guardian

3.2 Brothers / Sisters / Stepbrothers / Stepsisters who are earning, including those abroad

Present Civil Currently living

Status with family
Names of Brothers / Sisters No Highest degree School attended / Present job designation Previous Year's
Name of employer
who are earning level reached graduated (O fficial Job Title) Gross Income
Yes Abroad?
Yes No

3.3 Do any of your brothers/sisters/stepbrothers/stepsisters in 3.2 contribute to your family expenses ? 1 Yes 2 No
If yes, how much is the average monthly contribution? P ________ (excluding contributions mentioned in 2.20) Who contributes ?
7
3.4 Non-earning brothers / stepbrothers and sisters / stepsisters who are single and living with the family
(Note : For married applicants, include children's data whether or not they are studying)

Highe s t De gr e e R e ce ving Schola r s hip?

St udying School At t e nde d/ Gr a dua t e d Amount of Schola r s hip (t uit ion,
Fir s t Na me Ye a r of Bir t h or Ye a r Le ve l (ot he r t ha n STFAP)
a nd Loca t ion s t ipe nds , e t c) pe r s e me s t e r
Ye s No R e a che d Ye s No

3.5 What are the sources of income of the household ? (Please encircle all applicable items)

1 Business 4 Real estate rentals 7 Commissions

2 Practice of Profession (e.g. lawyer) 5 Salaries or wages 8 Dividends/ interests/earnings from investments
3 Farms/haciendas/fishponds 6 Remittances from abroad 9 Retirement pension
10 Others

3.6 Do you have any relatives, other than those in 3.2 (whether here or abroad), who contribute in meeting your family expenses? 1 Yes 2 No
If yes, how much is the average monthly contribution ? P _______/month
If assistance is not in cash, what kind of help do they give ? ________________________________________

3.7 Other household members (excluding household help) not listed in 3.1, 3.2 and 3.4

Name Relationship to Student Occupation (if working) Annual Gross Income

8
3.8 How many household help are living with or working for your family:

Number Total Monthly Salary

Maid(s) _________________________ _________________________
Houseboy(s) _________________________ _________________________
Yaya(s) _________________________ _________________________
Cook(s) _________________________ _________________________
Gardener(s) _________________________ _________________________
Driver(s) _________________________ _________________________
Other(s) _________________________ _________________________
_________________________ _________________________

Do you have a security guard ? 1 Yes 2 No

3.9 Does your family have any of the following household appliances and facilities? These include appliances which the
family owns, is amortizing or those owned by other persons or entities but are being used by the family. (DO NOT
LEAVE ANY BLANKS. Write 0 if your family does not have the appliance.)

N o . o f wo rking units Applia nc e s Ye ar Acquire d

C o mp o ne nt stereo s yste m
K a ra o k e
C o mp a ct d isc p la yer
P iano /e lect ric o rga n

B lack an d w hite TV
C o lo r T V
B etam ax o r V H S ma chin e
V id eo o r M o vie c amera (e.g. M inic amco rd e r)
L ase r D isc vid eo /vid e o k e

E lectric /G as /K ero se ne sto v e

G as o r Electric ran ge w ith o ve n
M ic ro w ave o ve n
Re frigerato r
F re eze r (up righ t o r che st typ e)

W a sh ing ma chin e
Electric c lo thes d ry er (no t sp inne r)
E lec tric fa n
A ir co nd itio ner

M icro co m p uter (e .g. IB M P C co mp atib le)

Elec tro nic ga me co mp u ter (e.g . S E G A )
C o rd less p ho ne (no t cell p h o ne)
C itizen s b and rad io (no t o rd inary rad io )

9
3.10 Facilities installed in your house/residence

1. Number of Telephone Units (land lines not cell phones): _________ Telephone Nos.: ________________

2. Piped or running water inside house 1 Yes 2 No

Amount paid for water last month
P __________ (Attach last month's bill)

3. Bathroom water heater 1 Yes 2 No

4. Number of bedrooms: ________

5. Number of toilets and/ or bathrooms: _________ Water sealed toilet 1 Yes 2 No

6. Approximate total floor area of house (sq.m.) ________

7. Electricity 1 Yes 2 No

8. Amount paid for electricity last month P _________________ (Attach last month's bill)

9. Electric Water pump/tank 1 Yes 2 No

3.11 Which of the following are owned by or provided to any member of the houseshold? Write 0 if none.

No.ofunits No.ofunits provided by

Name ofcompany providing device
Owned office orcompany
a.Cellular/mobile phone
b.Easycall/PocketBellor
similarmessage service

3.12 Does your family own or rent the house it is staying in? (encircle numeric code)

1 Own house (not mortgaged)

2 Own house (mortgaged): Monthly amortization P _________

3 Renting: Monthly rental (submit receipt) P _________

4 Neither own nor rent the house (submit Tax Declaration)

Name of owner _______________________________________________
Relationship of owner to family __________________________________
Contributions, if any, to house owner P______________ / month

10
3.13 Which of the following vehicles are owned by, are being amortized or provided by other persons/entities to any member of the
household? Be sure to include company cars and vehicles being used by any member of the family. Include also cars or vehicles
being lent by relatives or friends or owned by family business. DO NOT LEAVE BLANKS. Write 0 if none. It is important
to indicate the make and model year (e.g. COROLLA 1989)

No. of units Year & model of all vehicles No. of units provided Year & model of vehicles provided
owned Owned (e.g. 1984 Lancer) by office or company by office or company (e.g. 1984
Lancer)
a. Car or Van
b. Pajero, Trooper, Land
Cruiser, or similar vehicles
c. Owner-type jeep
d. Passenger jeepney
e. Asian Utility vehicle
(e.g Tamaraw)
f. Truck
g. Pick-up
h. Motorcycle
i. Tricycle
j. Others (specify)

If vehicle is provided by company,

a. Does your family own the company or stocks in the company? 1 Yes 2 No
b. Is car under a car plan? 1 Yes 2 No
If vehicle that is used by family or any member of the family is not owned by the family or any member of the family please
state for whom, by whom and for what purpose it is provided:

For whom By whom For what purpose

Example: brother United Drug used in sales / marketing

3.14 Private life insurance (exclude GSIS and SSS)

Parents / stepparents, spouse (if applicant is married) or guardian insured? 1 Yes 2 No
If yes, total face value ___________Total annual premium ______________

3.15 Does your family own any of the following? 1 Yes 2 No

If yes, fill out appropriate blanks
Face/Maturity Value
Certificate of time deposit P ____________________
Stocks P ____________________
Government bonds, including Treasury Bills P ____________________
Foreign currency deposits (specify currency, e.g. dollars)______________________

3.16 Does your father/stepfather / mother / stepmother / spouse (if applicant is married) or legal guardian have a credit card(s) ?
1 Yes 2 No
If yes, which type(s) of credit card(s) (check all applicable)
Foreign (e.g. American Express)
Local bank (e.g. Bankard, BPI Express Credit, Far East Card)
Local store (e.g. Shoemart)

11
3.17 Real estate property owned by, or registered in the name of, family whether fully paid or not:
Residential lots:

Area Location Latest Market Value

(in sq. meters) ( municipality / province / city) ( as per latest Tax Declaration )

Do you earn income from these lots? 1 Yes 2 No If yes, P __________/month

Is this amount included in the Income Tax Return? 1 Yes 2 No
Non-residential lots/agricultural lands

Area Location Latest Market Value

(in sq. meters) ( municipality / province / city) ( as per latest Tax Declaration )

Do you earn income from these lots? 1 Yes 2 No If yes, P __________/month

Is this amount included in the Income Tax Return? 1 Yes 2 No
Do you have farm animals, agricultural machinery, motorized banca ? 1 Yes 2 No

3.18 Buildings/houses owned or rented out to others (pinauupahan) by the family (e.g. apartment, factory, shop, warehouse, etc.,
including house in item 3.12)

Floor Area Location Monthly Rental Charged Latest Market Value

(municipality / province / (as per latest Tax
(in sq. meters)
city) Declaration)

Did you include this in the Income Tax Return ? 1 Yes 2 No

Do you have boarders/lodgers/bedspacers ? 1 Yes 2 No
If yes,total monthly rental P

Important Note to Student and Parents or Guardian

On the basis of its evaluation, the University reserves the right to determine whether the student deserves financial
assistance, and the kind and amount of assistance.

12
3.19 Are there special circumstances in your family which may help the University evaluate your financial need ?
1 Yes 2 No
If yes, state in the space provided below.

13
4.0 VICINITY SKETCH OF RESIDENCE (to enable U.P. fact-finding team to visit residence). Please indicate landmarks.

14
 PERSONAL STATEMENT OF ASSETS AND LIABILITIES OF
PARENTS/LEGAL GUARDIAN/SPOUSE

I, ______________________________________. of legal age, married and a resident of _______________________________

_____________________________________________________ , hereby state:

1. That my family's assets and liabilities as of December 31, 19_____, are as follows:
(a) ASSETS: (Personal and Real Properties):

Personal Properties Cost

Savings P _______________
Stocks/Investments _______________
Vehicles _______________
Jewelry _______________
Furniture _______________
Appliances _______________
Others _______________

TOTAL PERSONAL PROPERTIES P _______________

Total Market Value as of
Real Properties: latest Tax Declaration

Residential Lands P _______________

Non-residential Land/s P _______________

Residential Buildings P _______________

Non-residential Buildings P _______________

TOTAL REAL PROPERTIES P _______________

(b) LIABILITIES:* P _______________

_______________

TOTAL LIABILITIES P _______________

(c) NET WORTH: ........................................................................ P _______________

(Total Assets minus Total Liabilities)

2. That this personal statement is made to support the application for financial assistance under the Iskolar ng Bayan Program
(SEA) of _______________________________________
(name of student)

Printed Name and Signature of Parent/Legal Guardian/Spouse

* Note: If bank, housing, car or commercial loans, submit documents. If personal loan exceeds P 10,000, submit an affidavit.
15
 Part 3. STATEMENT

Statement of the Student

I hereby certify, upon my honor, that all the data and information which I have furnished are accurate and complete.
I understand that any misinformation and / or withholding of information will automatically disqualify me from receiving any
financial assistance, or subsidy, and may serve as ground for my expulsion from the University. Furthermore, if such
misinformation and / or withholding of information on my part is discovered after I have been awarded tuition scholarship
or any form of financial assistance, I will be required to reimburse all the financial benefits received plus all the legal rate
of interest prevailing at the time of reimbursement without prejudice to the filing of charges against me.

Moreover, I authorize the University to conduct a bank credit check and send a fact-finding team to visit my home /
residence to verify the veracity of the information provided in this application or to obtain additional information on my capacity
to pay and I will give my utmost cooperation in this regard. I understand that my refusal to comply with any of the above-
mentioned conditions may mean suspension or withdrawal of STFAP benefits and privileges.

__________________________________________

Student's Signature
Statement of the Applicant's Parent/Stepparent, Guardian or Spouse:

I hereby certify that I have read the entire questionnaire and that I certify to the truthfulness and completeness of the
information which my son/daughter/dependent/spouse has furnished in this application together with all the documents attached.
I understand that any misinformation and / or withholding of information will automatically disqualify him / her from receiving
any financial assistance, or subsidy, and may serve as ground for his / her expulsion from the University. I further recognize
that in signing this application form, I share with my son / daughter / spouse / dependent the responsibility for the
truthfulness and completeness of the information supplied herein.

Moreover, I authorize the University to conduct a bank credit check and send a fact-finding team to visit my home /
residence to verify the veracity of the information provided in this application and I will give my utmost cooperation in this regard.
I understand that my refusal to comply with any of the above-mentioned conditions may mean suspension or withdrawal
of STFAP benefits and privileges of my son / daughter / dependent / spouse.

__________________________________________

Parent's/Legal Guardian's/Spouse's Signature

Acknowledgement

REPUBLIC OF THE PHILIPPINES ) S.S.

)

BEFORE ME, a Notary Public for and in the above jurisdiction, this _____________ day of ___________________,
1994, personally appeared ______________________________ (name of Parent, Legal Guardian, Spouse) with Community
Tax Certificate No. __________________ issued at ____________________ on _______________, and
____________________________ (name of student if applicable), with Community Tax Certificate No. ____________________,
issued at ____________________________, on ________________, known to me to be same person(s) who executed the
foregoing instrument and all attachments and acknowledged to me that the same is their/his true act and deed.

IN WITNESS WHEREOF, I have hereunto set my hand and seal on the date and place herein above stated.

Doc. No. _________________

Page No. _________________
Book No. _________________ ________________________________
Series of 19 ________________
NOTARY PUBLIC
Until December 31, 1997
16