Student Organizations Recognition Requirements Annex A- 1 Organization Officer’s Information Sheet OR:08-00-FO20 ORGANIZATION OFFICER'S INFORMATION SHEET 1x1 Academic Year 2012-2013 ID PICTURE NAME OF ORGANIZATION ______________________________________ SURNAME FIRST NAME MIDDLE NAME SE X POSITION IN THE ORG [ ] Male [ ] Female NICKNAME FOR THE ID COURSE & SEC. CONTACT NUMBER / S RELIGION CITIZENSHIP Residence # DATE OF BIRTH mm - dd - yyyy PLACE OF BIRTH Mobile # ADDRESS E-mail Address & FaceBook Account Home Address E-Mail Provincial Address Facebook FATHER'S NAME MOTHER'S NAMES EDUCATIO N Educational Attainment Name and Location of Institution Degree Earned Year of Graduation Honors Received Elementary Seconday College Special Training RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University) Name of Organization Position Inclusive dates ACADEMIC ACHIEVEMENTS (Please enumerate) OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate) SPECIAL SKILLS To the best of my knowledge, the above facts as stated are true and correct. ___________________________________________ SIGNATURE
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S t u d e n t O r g a n i z a t i o n s R e c o g n i t i o n R e q u i r e m e n t s
A n n e x A - 1O r g a n i z a t i o n O f f i c e r ’ s I n f o r m a t i o n S h e e t
ORGANIZATION OFFICER'S INFORMATION SHEET 1x1
OR:08-00-FO20
ORGANIZATION OFFICER'S INFORMATION SHEET 1x1Academic Year 2012-2013 ID
PICTURE
NAME OF ORGANIZATION ______________________________________
SURNAME FIRST NAME MIDDLE NAME SEX POSITION IN THE ORG
[ ] Male [ ] Female
NICKNAME FOR THE ID
COURSE & SEC.
CONTACT NUMBER / S
RELIGION CITIZENSHIP Residence #
DATE OF BIRTH mm - dd - yyyy PLACE OF BIRTH Mobile #
ADDRESS E-mail Address & FaceBook Account
Home Address
E-Mail
Provincial Address
Facebook
FATHER'S NAME MOTHER'S NAMES
EDUCATION
Educational Attainment Name and Location of Institution Degree Earned
Year of Graduation Honors Received
Elementary
Seconday
College
Special Training
RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive dates ACADEMIC ACHIEVEMENTS (Please enumerate) OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
SPECIAL SKILLS
To the best of my knowledge, the above facts as stated are true and correct.
Educational Attainment Name and Location of Institution Degree Earned Year of Graduation Honors Received
Elementary
College of the Holy Spirit / Don Bosco Technical Institute 2004
Seconday Don Bosco Technical Institute - Tarlac 2008
College University of Santo Tomas
Special Training
RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive dates
DBTI – Student Council Business Manager 2007-2008
Taekwondo Varsity Captain 2007-2008
Service Emergency Volunteer Environmental Network Group (7G) Member 2006-onwardsACADEMIC ACHIEVEMENTS (Please enumerate) OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
Loyalty Awardee
Best in Taekwondo,
Best Leader in NSTP
SPECIAL SKILLS
To the best of my knowledge, the above facts as stated are true and correct.
FATHER'S NAME DANIEL LAPID MOTHER'S NAMES BERNADETH LAPID
EDUCATION
Educational Attainment Name and Location of Institution Degree Earned
Year of Graduation Honors Received
Elementary
SAN NICOLAS LEARNING CENTER GRADE 1 VALEDICTORIAN
WHIZ KID ACADEMY GRADE 2 – GRADE 6 2005 SALUTATORIAN
Secondary O.B MONTESSORI CENTER INC. (ANGELES) 1ST – 4TH YEAR 2009
College UNIVERSITY OF SANTO TOMAS PRESENT 2013 RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive dates JUNIOR PHARMACISTS’ ASSOCIATION – GAMMA CHAPTER
MEMBER
2009 – 2010
PHARMACY DANCE TROUPE MEMBER 2009 – 20102010 – 2011
PRO INTERNAL 2011 – 2012
SCARLET MEMBER 2010 – 2011ACADEMIC ACHIEVEMENTS (Please enumerate) VALEDICTORIANSALUTATORIANBEST IN READINGBEST IN VISUAL ARTSBEST IN COMPUTEROTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
SPECIAL SKILLS
DANCING
PLAYING VOLLEYBALL & BADMINTON
FLIPS(ACROBATICS)To the best of my knowledge, the above facts as stated are true and correct.
FATHER'S NAME Efren C. Benigno MOTHER'S NAMES Daisy P. Benigno
EDUCATION
Educational Attainment Name and Location of Institution Degree Earned
Year of Graduation Honors Received
Elementary University of Santo Tomas, Manila 2007 Honorable Mention
OR:08-00-FO20
S t u d e n t O r g a n i z a t i o n s R e c o g n i t i o n R e q u i r e m e n t s
A n n e x A - 10O r g a n i z a t i o n O f f i c e r ’ s I n f o r m a t i o n S h e e t
Seconday
St. Scholastica’s College, Manila 2011
College University of Santo Tomas, Manila
Special Training
RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive datesSSC Dance Troupe Senior member 2007-2009 Magnificat Vice President 2010- 2011 Gawad Kalinga Volunteer/member – St. Scholastica’s College 2010-2011ACADEMIC ACHIEVEMENTS (Please enumerate) Consistent top student in elementary Consistent merit awardee in High School OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
3rd place – Math Quiz bee, 2009
Service award – Magnificat Club, 2010
Semi-finalist – Inter-class debate, 2010
SPECIAL SKILLS
To the best of my knowledge, the above facts as stated are true and correct.
ORGANIZATION OFFICER'S INFORMATION SHEET 1x1Academic Year 2012-2013 ID
PICTURE
NAME OF ORGANIZATION ______________________________________
SURNAME FIRST NAME MIDDLE NAME SEX POSITION IN THE ORG
[ ] Male [ ] Female
NICKNAME FOR THE ID
COURSE & SEC.
CONTACT NUMBER / S
RELIGION CITIZENSHIP Residence #
DATE OF BIRTH mm - dd - yyyy PLACE OF BIRTH Mobile #
ADDRESS E-mail Address & FaceBook Account
Home Address
E-Mail
Provincial Address
Facebook
OR:08-00-FO20
S t u d e n t O r g a n i z a t i o n s R e c o g n i t i o n R e q u i r e m e n t s
A n n e x A - 11O r g a n i z a t i o n O f f i c e r ’ s I n f o r m a t i o n S h e e t
FATHER'S NAME MOTHER'S NAMES
EDUCATION
Educational Attainment Name and Location of Institution Degree Earned
Year of Graduation Honors Received
Elementary
Seconday
College
Special Training
RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive dates ACADEMIC ACHIEVEMENTS (Please enumerate) OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
SPECIAL SKILLS
To the best of my knowledge, the above facts as stated are true and correct.
ORGANIZATION OFFICER'S INFORMATION SHEET 1x1Academic Year 2012-2013 ID
PICTURE
NAME OF ORGANIZATION ______________________________________
SURNAME FIRST NAME MIDDLE NAME SEX POSITION IN THE ORG
[ ] Male [ ] Female
NICKNAME FOR THE ID
COURSE & SEC.
CONTACT NUMBER / S
RELIGION CITIZENSHIP Residence #
DATE OF BIRTH mm - dd - yyyy PLACE OF BIRTH Mobile #
ADDRESS E-mail Address & FaceBook Account
Home Address
E-Mail
Provincial Address
Facebook
OR:08-00-FO20
S t u d e n t O r g a n i z a t i o n s R e c o g n i t i o n R e q u i r e m e n t s
A n n e x A - 12O r g a n i z a t i o n O f f i c e r ’ s I n f o r m a t i o n S h e e t
FATHER'S NAME MOTHER'S NAMES
EDUCATION
Educational Attainment Name and Location of Institution Degree Earned
Year of Graduation Honors Received
Elementary
Seconday
College
Special Training
RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive dates ACADEMIC ACHIEVEMENTS (Please enumerate) OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
SPECIAL SKILLS
To the best of my knowledge, the above facts as stated are true and correct.
ORGANIZATION OFFICER'S INFORMATION SHEET 1x1Academic Year 2012-2013 ID
PICTURE
NAME OF ORGANIZATION ______________________________________
SURNAME FIRST NAME MIDDLE NAME SEX POSITION IN THE ORG
[ ] Male [ ] Female
NICKNAME FOR THE ID
COURSE & SEC.
CONTACT NUMBER / S
RELIGION CITIZENSHIP Residence #
DATE OF BIRTH mm - dd - yyyy PLACE OF BIRTH Mobile #
ADDRESS E-mail Address & FaceBook Account
Home Address
E-Mail
Provincial Address Facebook
OR:08-00-FO20
S t u d e n t O r g a n i z a t i o n s R e c o g n i t i o n R e q u i r e m e n t s
A n n e x A - 13O r g a n i z a t i o n O f f i c e r ’ s I n f o r m a t i o n S h e e t
FATHER'S NAME MOTHER'S NAMES
EDUCATION
Educational Attainment Name and Location of Institution Degree Earned
Year of Graduation Honors Received
Elementary
Seconday
College
Special Training
RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive dates ACADEMIC ACHIEVEMENTS (Please enumerate) OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
SPECIAL SKILLS
To the best of my knowledge, the above facts as stated are true and correct.
ORGANIZATION OFFICER'S INFORMATION SHEET 1x1Academic Year 2012-2013 ID
PICTURE
NAME OF ORGANIZATION ______________________________________
SURNAME FIRST NAME MIDDLE NAME SEX POSITION IN THE ORG
[ ] Male [ ] Female
NICKNAME FOR THE ID
COURSE & SEC.
CONTACT NUMBER / S
RELIGION CITIZENSHIP Residence #
DATE OF BIRTH mm - dd - yyyy PLACE OF BIRTH Mobile #
ADDRESS E-mail Address & FaceBook Account
Home Address
E-Mail
Provincial Address Facebook
OR:08-00-FO20
S t u d e n t O r g a n i z a t i o n s R e c o g n i t i o n R e q u i r e m e n t s
A n n e x A - 14O r g a n i z a t i o n O f f i c e r ’ s I n f o r m a t i o n S h e e t
FATHER'S NAME MOTHER'S NAMES
EDUCATION
Educational Attainment Name and Location of Institution Degree Earned
Year of Graduation Honors Received
Elementary
Seconday
College
Special Training
RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive dates ACADEMIC ACHIEVEMENTS (Please enumerate) OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
SPECIAL SKILLS
To the best of my knowledge, the above facts as stated are true and correct.
ORGANIZATION OFFICER'S INFORMATION SHEET 1x1Academic Year 2012-2013 ID
PICTURE
NAME OF ORGANIZATION ______________________________________
SURNAME FIRST NAME MIDDLE NAME SEX POSITION IN THE ORG
[ ] Male [ ] Female
NICKNAME FOR THE ID
COURSE & SEC.
CONTACT NUMBER / S
RELIGION CITIZENSHIP Residence #
DATE OF BIRTH mm - dd - yyyy PLACE OF BIRTH Mobile #
ADDRESS E-mail Address & FaceBook Account
Home Address
E-Mail
Provincial Address
Facebook
OR:08-00-FO20
S t u d e n t O r g a n i z a t i o n s R e c o g n i t i o n R e q u i r e m e n t s
A n n e x A - 15O r g a n i z a t i o n O f f i c e r ’ s I n f o r m a t i o n S h e e t
FATHER'S NAME MOTHER'S NAMES
EDUCATION
Educational Attainment Name and Location of Institution Degree Earned
Year of Graduation Honors Received
Elementary
Seconday
College
Special Training
RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive dates ACADEMIC ACHIEVEMENTS (Please enumerate) OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
SPECIAL SKILLS
To the best of my knowledge, the above facts as stated are true and correct.
ORGANIZATION OFFICER'S INFORMATION SHEET 1x1Academic Year 2012-2013 ID
PICTURE
NAME OF ORGANIZATION ______________________________________
SURNAME FIRST NAME MIDDLE NAME SEX POSITION IN THE ORG
[ ] Male [ ] Female
NICKNAME FOR THE ID
COURSE & SEC.
CONTACT NUMBER / S
RELIGION CITIZENSHIP Residence #
DATE OF BIRTH mm - dd - yyyy PLACE OF BIRTH Mobile #
ADDRESS E-mail Address & FaceBook Account
Home Address
E-Mail
Provincial Address Facebook
OR:08-00-FO20
S t u d e n t O r g a n i z a t i o n s R e c o g n i t i o n R e q u i r e m e n t s
A n n e x A - 16O r g a n i z a t i o n O f f i c e r ’ s I n f o r m a t i o n S h e e t
FATHER'S NAME MOTHER'S NAMES
EDUCATION
Educational Attainment Name and Location of Institution Degree Earned
Year of Graduation Honors Received
Elementary
Seconday
College
Special Training
RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive dates ACADEMIC ACHIEVEMENTS (Please enumerate) OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
SPECIAL SKILLS
To the best of my knowledge, the above facts as stated are true and correct.
ORGANIZATION OFFICER'S INFORMATION SHEET 1x1Academic Year 2012-2013 ID
PICTURE
NAME OF ORGANIZATION ______________________________________
SURNAME FIRST NAME MIDDLE NAME SEX POSITION IN THE ORG
[ ] Male [ ] Female
NICKNAME FOR THE ID
COURSE & SEC.
CONTACT NUMBER / S
RELIGION CITIZENSHIP Residence #
DATE OF BIRTH mm - dd - yyyy PLACE OF BIRTH Mobile #
ADDRESS E-mail Address & FaceBook Account
Home Address
E-Mail
Provincial Address Facebook
OR:08-00-FO20
S t u d e n t O r g a n i z a t i o n s R e c o g n i t i o n R e q u i r e m e n t s
A n n e x A - 17O r g a n i z a t i o n O f f i c e r ’ s I n f o r m a t i o n S h e e t
FATHER'S NAME MOTHER'S NAMES
EDUCATION
Educational Attainment Name and Location of Institution Degree Earned
Year of Graduation Honors Received
Elementary
Seconday
College
Special Training
RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive dates ACADEMIC ACHIEVEMENTS (Please enumerate) OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
SPECIAL SKILLS
To the best of my knowledge, the above facts as stated are true and correct.
ORGANIZATION OFFICER'S INFORMATION SHEET 1x1Academic Year 2012-2013 ID
PICTURE
NAME OF ORGANIZATION ______________________________________
SURNAME FIRST NAME MIDDLE NAME SEX POSITION IN THE ORG
[ ] Male [ ] Female
NICKNAME FOR THE ID
COURSE & SEC.
CONTACT NUMBER / S
RELIGION CITIZENSHIP Residence #
DATE OF BIRTH mm - dd - yyyy PLACE OF BIRTH Mobile #
ADDRESS E-mail Address & FaceBook Account
Home Address
E-Mail
Provincial Address Facebook
OR:08-00-FO20
S t u d e n t O r g a n i z a t i o n s R e c o g n i t i o n R e q u i r e m e n t s
A n n e x A - 18O r g a n i z a t i o n O f f i c e r ’ s I n f o r m a t i o n S h e e t
FATHER'S NAME MOTHER'S NAMES
EDUCATION
Educational Attainment Name and Location of Institution Degree Earned
Year of Graduation Honors Received
Elementary
Seconday
College
Special Training
RECORD OF EXTRA-CURRICULAR ACTIVITIES (Inside and Outside of the University)
Name of Organization Position Inclusive dates ACADEMIC ACHIEVEMENTS (Please enumerate) OTHER AWARDS RECEIVED IN HIGH SCHOOL AND COLLEGE (Please enumerate)
SPECIAL SKILLS
To the best of my knowledge, the above facts as stated are true and correct.