SIMPLICIO GAMBOA SR. FOUNDATION INC.SGS Foundation Bldg., 1335 G. Araneta Avenue, Quezon City

Email: [email protected]: www.sgsfoundation.org.ph

Contact No. 414-6241 loc. 846

SCHOLARSHIP RENEWAL FORM

NAME OF SCHOLAR: NICKNAME:

PRESENT HOME ADDRESS:

EMAIL ADDRESS: TEL. NO.: MOBILE NO.:

COLLEGE/UNIVERSITY: COURSE: SCHOOL YEAR: YEAR LEVEL:

REPORT OF GRADESSUBJECT CODE SUBJECT GRADE UNIT/S TOTAL

TOTAL NUMBER OF SUBJECTS: ______________________TOTAL NUMBER OF UNITS: ______________________GENERAL WEIGHTED AVERAGE: ______________________

SCHOLARSHIP RENEWAL UNDERTAKING

I fully accept the hereunder rules and policies of the SGS Foundation Scholarship:

I shall apply for the renewal of my Scholarship Grant every end of semester, which shall include Summer Term if prescribed in the Curriculum;

I shall coordinate and seek approval from SGS Foundation on any decision regarding my Scholarship; I shall submit ALL required scholarship documentations, as applicable, on or before the week prior to the start of the

semester, which shall include the following:

__ Original Official Receipt/Proof of Payment from the previous semester; __ *Photocopy and Original Copy of Grades of the previous semester; __ Photocopy of Pre-Registration/Certificate of Registration for the following/current semester; __ Photocopy of Pre-Assessment/Assessment of Fees for the following/current semester; __ Letter of Appeal (for those with GWA lower than the maintaining grade of 2.0 or 85%)

I shall continually uphold the honor and prestige of the Foundation by being an exemplary student by complying all rules and regulations of SGS Foundation and the College/University I am enrolled in.

In case of violation on the foregoing conditions, I respect the right of SGS Foundation to impose disciplinary action or termination of Scholarship as the case may be.

_________________________________ ________________ Signature over Printed Name of Scholar Date

*Scholars from Partner Colleges/Universities shall have their Photocopy of Grades verified and signed by its Scholarship Coordinator.

. DATE RECEIVED: ____________ PROCESSED BY: ____________

SCHOLARSHIP STATUS:

( ) RENEWED REMARKS:______________________________________________________________________________________________________________________________

( ) TERMINATED

___________________________APPROVING OFFICER