UNIVERSITY OF SAN CARLOS
ENGINEERING RESEARCH AND DEVELOPMENT FOR TECHNOLOGY
(ERDT) SCHOLARSHIP PROGRAM
Attach here 1 latest
passport size picture
APPLICATION FORM
TYPE OF SCHOLARSHIP APPLIED FOR:
ME
MS
DE
PhD
Program of Study: _______________________________________________________________
(e.g., Civil Engineering)
Research Areas of Interest:
(1) __________________________________________________
(2) __________________________________________________
(3) __________________________________________________
QUALIFICATIONS:
1. Must be a Filipino Citizen
2. Must not be over 45 years of age
3. Must have a BS degree in engineering or related field (for MS applicants)
4. Must have a MS degree in engineering or related field (for PhD applicants)
5. Must be in good health
6. Must not have criminal/administrative cases (NBI certification is required)
7. Must be enrolled as a full-time graduate student
8. Must not have other scholarship contract
9. Must be willing to render the required service obligation equivalent to the length of time
that the scholar enjoyed the scholarship – One year of service for every year of scholarship
or a fraction thereof
10. Must have a full-time commitment to the scholarship and must not be engaged in any form
of employment during the scholarship.
Deadline of Submission of Application:
First Semester – April 30
Second Semester – September 15
_ _ _ _ _ _ _ __ _ _ _ _ _ _ __ _ _ _ _ _ _ __ _ _ _ _ _ _ __ _ _ _ _ _ _ __ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _
CHECKLIST OF REQUIRED DOCUMENTS (for staff use only)
Curriculum Vitae
Birth Certificate (Photocopy)
Certified True Copy of Grades/Transcript of Records
Recommendation letter from 3 past professors or supervisors (see attached sheet)
Narrative essays (Career plans)
If employed, must be recommended by the head of agency and secure permission to take a
leave of absence while on scholarship
Medical Certificate as to health status from a licensed physician indicating PRC License No.
Valid NBI Clearance
One passport size picture
INFORMATION SHEET
I. PERSONAL INFORMATION
a.
Last Name
First Name
Permanent Address: No.
Street
Middle Name
b.
City/Municipality
Province
c.
Zip Code
Region
District
Passport No.
E-mail address
d.
Current Mailing Address
e.
Telephone Nos. (Landline/Mobile)
f.
Civil Status
Date of Birth
Age
Sex
g.
Name of Parents (Father)
(Mother)
Address
II. GRADUATE SCHOLARSHIP INTENTIONS DATA
New Applicant
a. University where you applied/intend to enrol
for graduate studies
b. Course/Degree
Lateral Applicant
a. University Enrolled in
b. Course/Degree
c. Number of units
earned
d. GWA
e. No. of remaining sems
III. CAREER/EMPLOYMENT INFORMATION
a. Present Employment Status:
( ) Permanent ( ) Contractual
( ) Probationary
( ) Self-employed
( ) Unemployed
a.1 For those who are presently employed
Position
Length of Service
Name of Company/Office
Address of Company/Office
E-mail
Website
Telephone No.
Fax No.
a.2 For those who are self-employed
Business Name
Address
Email/Website
Tel. No.
Type of Business
Years of Operation
* Once accepted into the scholarship program, the scholar must obtain permission to take a leave of absence
from his/her employer and become a full –time student. The scholar must submit a letter/ certification from
his/her employer agreeing to the leave.
b. CARRER PLANS (Write in a separate paper)
b1. A narrative, not more than 1000 words, describing your current work or a project
(or research) that you worked on and your contribution towards the completion of the
project.
b2. Future Plans (After Graduation)
b3. For PhD applicants, a narrative describing your intended research area
IV. RESEARCH AND DEVELOPMENT INVOLVEMENT (last five years)
Use additional sheet if necessary.
FIELD AND TITLE OF RESEARCH
LOCATION/DURATION
FUND SOURCE
NATURE OF
INVOLVEMENT
V. PUBLICATIONS (last five years)
Use additional sheet if necessary.
TITLE OF ARTICLE/PUBLICATION
PLACE/YEAR OF PUBLICATION
NATURE OF INVOLVEMENT
AWARD GIVING BODY
YEAR OF AWARD
VI. AWARDS RECEIVED
Use additional sheet if necessary.
TITLE OF AWARD
I hereby certify that all information given above are true and correct to the best of my knowledge.
Signature of Applicant
Date _____________________
* How did you know ERDT?
- University/campus roadshow
- Friend
- ERDT scholar
- others (please specify):___________________________________
Please submit this form with together with the requirements to ERDT office:
Lawrence Bunzel Building, 2nd Floor, Room 201
College of Engineering, University of San Carlos
NasipitTalamban Campus, Cebu City, 6000
LETTER OF RECOMMENDATION
FOR ADMISSION TO ERDT SCHOLARSHIP PROGRAM
To be completed by applicant (Please type or Print)
Name: ______________________________________________________
Current Address: ______________________________________________________
Degree program applied for: ______________________________________________________
Start of graduate study:
1st semester
2 nd semester
AY _______-_______
Note to applicant: Ask your recommender to enclose this form in an envelope, seal the envelope, and sign
across the seal. Submit the envelop with its seal unbroken with the rest of your application materials to:
Lawrence Bunzel Building, 2nd Floor, Room 20, College of Engineering, University of San Carlos
NasipitTalamban Campus, Cebu City, 6000
To be completed by recommender
Any pertinent information regarding the applicant and your evaluation of the applicant’s ability to
undertake graduate studies and research will be held in strict confidence.
How long have you known the applicant? ________________________________________________________
In what capacity have you known the applicant? _________________________________________________
If the applicant was a student in some of your classes, what were these subjects? _______________________
_____________________________________________________________________________________________
What do you consider as the applicant’s outstanding talents or strengths in relation to graduate study?
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
What do you consider as his/her weakness or deficiencies in relation to graduate study __________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Please rate the applicant on the following characteristics in comparison with other students in the same
disciplines who are known to you and who have had more or less the same amount of training and
experience. (Indicate size of group with which applicant is being compared _____________________ and its
educational level _________________).
Excellent
Above
Average
Average
Below
Average
Inadequate
basis for
judgment
1. Intellectual ability
2. Academic preparation for proposed field of study
3. Motivation for proposed field of study
4. Originally, creativity & imagination
5. Analytical & problem-solving ability
6. Initiative and independence
7. Honesty & integrity
8. Conscientiousness & ability to work independently
9. Ability to work with others
10. Oral communication skills
11. Written communication skills
12. Emotional maturity
13. Potential as a researcher in the discipline
14. Potential as a teacher in the discipline
Additional information and comments about the applicants (please use a separate sheet of paper, if
necessary).
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
I therefore
strongly recommend
recommend
recommend with reservations
recommend the applicant for admission to graduate studies in your college.
do not
Recommender’s Printed Name: __________________________________________________________________
Recommender’s Signature: _________________________________________ Date: ______________________
Position: ___________________________________ Highest Educational Attainment: _____________________
Name and Address of Organization: ______________________________________________________________
*Note to recommender: Please enclose this form in an envelope, seal the envelope, sign across the seal, and return
sealed envelope to applicant.