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Degree Program Application Form
BAR application form for degree scholarship program
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Department of Agriculture
Bureau of Agricultural Research
RDMIC Bldg., Elliptical Rd. Cor. Visayas Ave., Diliman, Q.C. 1104
Phone Nos.: (632) 928-8624 & 928-8505 Fax: (632) 927-5691
Email: rd@bar.gov.ph Website: http//www.bar.gov.ph
Degree Scholarship Program
APPLICATION FORM
Instructions: Complete the application form and affix you signature where required. Place
NA where not applicable. Check appropriate box.
Picture
2” x 2”
Date of Application:
1. Degree:
M.S.
Ph.D.
2. Course/Field of Specialization:
3. Institution:
UP Los Baños
UP Diliman
UP Visayas
Ateneo de Manila
4. Date Admitted:
USM
MSU – Naawan
Dela Salle University
San Carlos, Cebu
LSU
CLSU
Siliman University
BSU
Target Date of Enrollment:
Target Date of Completion:
5. Type of Scholarship Grant Application:
Full Support
Additional Support (for those who have availed support from
other agency)
For those who are presently/ previously enrolled, please answer question no. 6
6. School Year Started:
Graduate Units Earned:
Graduate Units to be Completed:
7. Name of Applicant:
8. Date of Birth:
Age:
9. Home Address:
Phone/Mobile No.
10. Sex:
Male
Female
Email
Marital Status:
Single
Widowed
Married
Separated
11. Tertiary Educational Background:
(List chronologically starting with the most recent, use extra sheet when necessary.)
School/University
Date Graduated
Degree/Course
12. Degree Scholarship(s) enjoyed (Local and Foreign)
Name of Scholarship/Country
DOCUMENT NO.:
REVISION NO.:
BAR/QSF-D.01.01
00
Degree
Duration
REVISION DATE:
EFFECTIVITY DATE:
09 September 2005
Degree Scholarship Program APPLICATION FORM
Page 2 of 4
13. Work Experience:
(Start with the latest, except for the present employer. Please use extra sheet when necessary.)
Employer/Address
Position Held
Duties and Percent Time Devoted
to Each*
Inclusive Dates
* Research(R ), Development/Extension (DE), Administration(A), Instruction (I) others
14. Present Employer:
Employer/Address
Position Held
Duties and Percent Time Devoted
to Each*
Inclusive Dates
* Research(R ), Development/Extension (DE), Administration(A), Instruction (I) others
Nature of Appointment:
15. Office Address:
Phone No.:
Email:
Fax:
16. Short Description of Duties and Responsibilities:
17. Please describe briefly how this scholarship will be useful in your work:
DOCUMENT NO.:
REVISION NO.:
BAR/QSF-D.01.01
00
REVISION DATE:
EFFECTIVITY DATE:
09 September 2005
Degree Scholarship Program APPLICATION FORM
Page 3 of 4
18. Proposed study plans:
(Proposed major Field of study and specific areas of specialization)
19. Training/Workshop/Conference Attended:
(Use extra sheet for additional entries, using the same format below.)
Title
Nature of
Participation **
Location
Inclusive
Dates
** Resource person or trainee
DOCUMENT NO.:
REVISION NO.:
BAR/QSF-D.01.01
00
REVISION DATE:
EFFECTIVITY DATE:
09 September 2005
No. of
Hrs
Degree Scholarship Program APPLICATION FORM
Page 4 of 4
20. On-Going and Completed Researches/Publications:
(Use extra sheet for additional entries, using the same format below.)
Title
Designation ***
Date
*** Study leader or researcher
I declare under penalties of perjury that the answers given above are true and correct to the
best of my knowledge and belief.
Signature of Applicant
ATTACHMENTS: 1. Certificate of admission from the accredited university 2. Transcript of records obtained from
the latest degree 3. Nomination from the Agency Head indicating that the course/degree is a priority need
of the agency/ in line with the HRD plan of the agency and the applicant is entitled receive salary and
other benefits during the scholarship 4. HRD Plan of the Agency 5. Latest service record certified by the
Chief of Personnel of the Agency 6. List of actual duties and responsibilities certified by immediate supervisor
7. Certification of performance ratings for the last 2 rating periods 8. Curriculum Vitae. For those who are
already enrolled: Include program of course work-indicate the subjects taken and to be taken in all
semester/summer NOTE: Attachments should be in short (8.5” x 11”) bond paper; documents can be reduced
if necessary; Application Form has 4 pages. FOR DETAILS: Call (02) 920-0219.
DOCUMENT NO.:
REVISION NO.:
BAR/QSF-D.01.01
00
REVISION DATE:
EFFECTIVITY DATE:
09 September 2005
