Application Form For ROC Taiwan Scholarship
Application Form For ROC Taiwan Scholarship
Application Form For ROC Taiwan Scholarship
This application form should be TYPED and completed by the applicant. If necessary, additional pages of the same size may be attached.
Please attach a photograph that has been taken within the last 3 months.
1. PERSONAL DATA
NAME
SALAZAR
(Last name)
RENATO
(Given Name) (Chinese Name, if applicable)
FATHERS NAME
SALAZAR
(Last name)
FORTUNATO SR.
(Given Name) (Chinese Name, if applicable)
MOTHERS NAME
ULEP
(Last name)
NENA
(Given Name) (Chinese Name, if applicable)
Note: If one or both of your parents were an ROC national at the time of your birth, you are an ROC national as well and therefore not eligible to apply.
FILIPINO
(dd/mm/yy) 28, APRIL 1990 21 BALER, AURORA
Single Married
Female Male
Email: [email protected]
HEALTH CONDITION ANY CHRONIC DISEASES CONTACT PERSON, IN CASE OF EMERGENCY
2. LANGUAGE PROFICIENCY
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LANGUAGE PROFICIENCY
COMPREHENSION
Excellent
READING
Excellent
WRITING
Fair
Excellent
SPEAKING
Fair
Excellent
Good
Fair
Good
Good
Good
Fair
CHINESE ENGLISH
3. EDUCATIONAL BACKGROUND
Level
Secondary Education Undergraduate Level Education
Name of Institution
Degree Major
Country/City
Period of Enrollment
Baler National High School Aurora State College of Technology (ASCOT) Bachelor of Science in Civil Engineering
Philippines Philippines
2002-2006 2006-2011
4. EMPLOYMENT RECORD
Experience Previous Previous Present Position Company/Organization
Employment Period
Provincial Engineering Office Provincial Engineering Office Aurora State College of Technology
to to
5. REFERENCES
Name Eusebio V. Angara Christopher Paladio Position President College Engineer Company Aurora State College Of Technology (ASCOT) Aurora State College Of Technology (ASCOT)
Phone, Mobil, Email, Address
6. PLEASE BRIEFLY STATE YOUR STUDY PLAN WHILE IN TAIWAN On my first year in Taiwan, it is my plan to attend orientation program, learn how to speak Mandarin language, attend different trainings and laboratory works set by the school, study different modules, and also plan for my Thesis On the second year, Ill work with the research process until I finalize my thesis as I continue studying different modules.
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For the whole duration of my stay in Taiwan, it is my plan to abide by their rules and regulations, respect their values and cultures, and achieve academic excellence as well as personality and professional development.
Applicants Signature
Date
March 3, 2012
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