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    University of The Philippines Los Baños: Application Form Undergraduate Student Assistantship

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    Jaydison Aniwer
    This document is an application form for an undergraduate student assistantship at the University of the Philippines Los Baños. It collects information such as the applicant's name, student ID number, major, contact details, parents' occupations, academic performance in previous semesters, number of enrolled units for the current semester, proposed work assignment and schedule. If accepted, the student will work a maximum of 30 hours per month under a department supervisor, earning PHP 30 per hour.

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    University of The Philippines Los Baños: Application Form Undergraduate Student Assistantship

    Uploaded by

    Jaydison Aniwer
    11 views3 pages
    This document is an application form for an undergraduate student assistantship at the University of the Philippines Los Baños. It collects information such as the applicant's name, student ID number, major, contact details, parents' occupations, academic performance in previous semesters, number of enrolled units for the current semester, proposed work assignment and schedule. If accepted, the student will work a maximum of 30 hours per month under a department supervisor, earning PHP 30 per hour.

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    This document is an application form for an undergraduate student assistantship at the University of the Philippines Los Baños. It collects information such as the applicant's name, student ID number, major, contact details, parents' occupations, academic performance in previous semesters, number of enrolled units for the current semester, proposed work assignment and schedule. If accepted, the student will work a maximum of 30 hours per month under a department supervisor, earning PHP 30 per hour.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    11 views3 pages

    University of The Philippines Los Baños: Application Form Undergraduate Student Assistantship

    Uploaded by

    Jaydison Aniwer
    This document is an application form for an undergraduate student assistantship at the University of the Philippines Los Baños. It collects information such as the applicant's name, student ID number, major, contact details, parents' occupations, academic performance in previous semesters, number of enrolled units for the current semester, proposed work assignment and schedule. If accepted, the student will work a maximum of 30 hours per month under a department supervisor, earning PHP 30 per hour.

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    OSA-SFAD Form #3

    Revised October 2010

    UNIVERSITY OF THE PHILIPPINES LOS BAOS


    APPLICATION FORM
    UNDERGRADUATE STUDENT ASSISTANTSHIP

    Name: ___________________________________________

    College: ________________

    (Print Name & Sign above)

    Student Number: ____________________________________


    Classification: ______________________________________

    Degree: ________________
    Major: _________________

    (OF/SO/JR/SR/SR- graduating/transferee)
    Campus/Present Address: _________________________________________________________________
    Provincial Address: ______________________________________________________________________
    Contact Info: _____________________
    Occupation of Mother: __________________________
    Occupation of Father: ___________________________
    For Old and Transfer Students:
    :
    : List of Subjects and Grades in the previous semester:
    : __________Semester 20_____ - 20_____
    Other scholarships/
    :
    Academic Subjects
    Units
    Grades
    grant/award:
    : _____________________
    ________
    __________
    _______________
    : _____________________
    ________
    __________
    : _____________________
    ________
    __________
    Other financial
    : _____________________
    ________
    __________
    Assistance/privilege : _____________________
    ________
    __________
    _________________
    : _____________________
    ________
    __________
    : _____________________
    ________
    __________
    :
    Total
    ________ Ave._________
    : Non-Academic
    : _____________________
    ________
    __________
    : _____________________
    ________
    __________
    ----------------------------------------------------------------------------------------------------------------------Number of registered units this semester: _________ Semester 20_____ - 20 ____
    Academic _________ Non- Academic _____________
    STFAP Bracket
    Assignment: ________

    Certified Correct by:


    ________________________
    College Secretary

    ----------------------------------------------------------------------------------------------------------------------------------------III. Department/Office where student will work: _________________________________________________


    Immediate Supervisor (w/ signature): _____________________________________________________
    Work to be accomplished_______________________________________________________________
    _____________________________________________________________________
    Maximum work hours per month: _______________
    Rate per hour P30.00
    Date of effectivity: From: Upon Approval to _______________
    Account Code: STFAP

    ---------------------------------------------------------------------------------------------------------------------RECOMMENDED FOR APPROVAL:

    BUDGET CLEARANCE:

    1. _____________________________

    4.

    Dean/Director/Chairman

    2.

    ETHEL T. CABRAL
    Chief, Budget Management Office

    APPROVED / DISAPPROVED:
    Head, Scholarships & Financial Asst. Div.
    5.

    3.
    Director, OSA

    _________
    date

    OSCAR B. ZAMORA
    Vice-Chancellor for Instruction

    REMARKS: __________________ State whether original,renewal,vice whom,etc. If transfer, state from what department and if replacing another
    student, state the reason why the incumbent student was replaced viz, resigned, transferred graduated.
    Note: Accomplish in five (5) copies. Return to SFAD-OSA after signature of Dean/Director

    V. Schedule of Classes:
    TIME
    8:00 - 8:30
    8:30 - 9:00
    9:00 - 9:30
    9:30 - 10:00
    10:00 -10:30
    10:30 -11:00
    11:00 -11:30
    11:30 -12:00
    12:00 -12:30
    12:30 - 1:00
    1:00 - 1:30
    1:30 - 2:00
    2:00 - 2:30
    2:30 - 3:00
    3:00 - 3:30
    3:30 - 4:00
    4:00 - 4:30
    4:30 - 5:00
    Work Schedule:
    TIME
    8:00 - 8:30
    8:30 - 9:00
    9:00 - 9:30
    9:30 - 10:00
    10:00 -10:30
    10:30 -11:00
    11:00 -11:30
    11:30 -12:00
    12:00 -12:30
    12:30 - 1:00
    1:00 - 1:30
    1:30 - 2:00
    2:00 - 2:30
    2:30 - 3:00
    3:00 - 3:30
    3:30 - 4:00
    4:00 - 4:30
    4:30 - 5:00

    Monday

    Tuesday

    Wednesday

    Thursday

    Friday

    Monday

    Tuesday

    Wednesday

    Thursday

    Friday

    1. Why are you applying for assistantship?


    ______________________________________________________________________________
    2. Where and when was your last assignment as Student Assistant? (indicate dept/unit,
    semester/summer)
    ______________________________________________________________________________
    3. Do you know how to type? ________
    4. Are you computer literate? ________. Indicate the software/programs you are knowledgeable
    with._____________________________
    _____________________________________________________________________________________
    To the Department /Unit Head:
    It is understood that my failure to report for a continuous period of three (3) weeks without
    prior notice at all to my immediate superior shall mean that I am no longer interested to render my
    service/s as Student Assistant, therefore I may be replaced.

    _____________________________
    Signature of Applicant

    _____________________________
    Signature of Immediate Supervisor

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