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Thesis Grant

CHED application form for thesis grant

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CHED THESIS GRANT

1.

Name of nominee/applicant ________________________________________________________
(First)
(Middle)
(Last)

2.
3.
4.
5.
6.
7.

Date and place of birth
Mailing/Office address and telephone/fax number
Residence and telephone number
E-mail address
Civil status (If married, please indicate name of spouse and children)
Educational background (Indicate school/university address, degree and year obtained, inclusive
dates of attendance, honors/awards received)
Present position
Subjects currently taught
Previous positions in chronological order
Title of thesis proposal
Discipline of study
Degree program
Name and address of University/College where the candidate grantee is enrolled
Name of Thesis Adviser
Work Plan/Time Table

8.
9.
10.
11.
12.
13.
14.
15.
16.

Activities
Approval of Thesis Proposal
Data Collection and Encoding
Data Analysis
Report Writing
Expected Date of Defense
Expected Completion Date of Master’s Program

Expected Date of Completion

17. Total Amount and Detailed Budget of Financial Assistance sought from CHED Thesis Grant
Item

* Please indicate other source (s) of financial support including the amount

Amount

18.
19.
20.
21.
22.

Thesis Panel/Committee Members (Name and Designation)
Awards received (indicate year received and name of awarding institution/organization)
GPA in the Course leading to the program applied for
Research Publications (Give complete citation and include manuscript in press)
Research papers and studies completed or in progress (indicate where or when conducted, date
completed or expected date of completion, and include only those not listed in item 20)
23. Membership in professional organizations (indicate position/nature of involvement)
24. Conferences/seminars and extent of participation, i.e. whether as chairperson, resource person,
convenor, participant, etc.

This is to certify the correctness of the information presented above.

______________________________________________
Name & Signature of the Faculty Applicant
Date: ________________

_______________________________
Name & Signature of the School Head
Date: _____________

Note: Please submit two (2) copies of the accomplished application form with the following
attachments/documents (a) approved thesis proposal including a one page abstract; (b) two recent 2”x2”
photographs; (c) letter of recommendation from the thesis adviser; (d) endorsement letter from the
applicant’s mother institution; (e) photocopy of the latest enrollment/registration form; (f) certification of
grades; and (g) approval sheet of the proposed thesis work including comments from the panel.

IBM/LAN/C:/OPPRI-RD/NHERA/Dissertation/Thesis Grant Application form 1-12-05
 
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