Instructions:

1. Open the link to any browser (Chrome, Brave, Mozilla, etc.)
2. Read General and Documentary Requirements. Click here
3. Fill in all the required information. Do not leave an item blank. If item is not applicable, input "NA"
4. Try to limit File Size uploading to 2MB or lower
5. Check Image/Document File-Type before proceeding:
     • Accepted File Type: JPEG, JPG, PNEG & PDF File.

Instructions: Read General and Documentary Requirements. Fill in all the required information. Do not leave an item blank. If item is not applicable, input "NA"

Personal Information

Last Name

First Name

Middle Name

Ext. Name

Birthdate

Place of Birth

Sex Male Female

Civil Status Single Married Widowed Annulled Separated Others

Citizenship

Province AbraApayaoBenguetIfugaoKalingaMountain Province

Street/Barangay

Town

District

Zip Code

Mobile No. *

Email Address (active)

Facebook Account name

Family Background

FATHER

Deceased

Highest Educational Attainment No grade completed Elementary Undergraduate Elementary Graduate High School Undergraduate High School Graduate Post Secondary Undergraduate Post Secondary Graduate College Undergraduate College Graduate Post Baccalaureate

MOTHER

Deceased

Highest Educational Attainment No grade completed Elementary Undergraduate Elementary Graduate High School Undergraduate High School Graduate Post Secondary Undergraduate Post Secondary Graduate College Undergraduate College Graduate Post Baccalaureate

LEGAL GUARDIAN. (Don't reinstate name of Parents)

Highest Educational Attainment No grade completed Elementary Undergraduate Elementary Graduate High School Undergraduate High School Graduate Post Secondary Undergraduate Post Secondary Graduate College Undergraduate College Graduate Post Baccalaureate

No. of siblings in the family

Parent(s)/Guardian Annual Gross Income

Is your family a beneficiary of the DSWD's Pantawid Pamilyang Pilipino Program (4ps)?

YES

NO

Academic Information

Applicant's Type Graduating SH Graduated SH

LRN

Year Level in AY 2026-2027 1

Senior High School Graduated

Computed GWA

SHS Address

SHS Type Public Private

HEI to Enroll/Enrolled In Benguet State University

HEI Address

HEI Type Public Private

Degree Program/Course (Priority Course) Bachelor of Science in Applied StatisticsBachelor of Science in Statistics

Additional Academic Information

Are you enjoying other source of educational/financial assistance?

YES

NO

Type of Scholarship

Grantee Institution/Agency

Other Information & Attachments

Indigenous People (IP) - Ethnic Group ex. Kankana-ey, Ibaloy, Tuwali,etc.

Please specify membership:

Solo Parent (Parent of Applicant)

Person with Disability (PwD)

If yes, select Type of Disability Communication Disability Disability due to Chronic Illness Learning Disability Intellectual Disability Orthopedic Disability Mental/Psychosocial Disability Visual Disability Others

Please specify:

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2x2 ID Picture (Image file)

Choose file

Birth Certificate

Choose file

Grade 12 Report Card (Incoming 1st Year) /
Previous Semester Grade (Ongoing College) (front)

Choose file

Grade 12 Report Card (Incoming 1st Year) /
Previous Semester Grade (Ongoing College) (back)

Choose file

Income Requirement

Choose file

Other Attachments (if needed)

Choose file

I hereby certify that foregoing statements are true and correct to the best of my knowledge.

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