SGS-L Special Request Forms - Request For Extension

SCHOLARSHIPS FOR GRADUATE STUDIES - LOCAL
REQUEST FOR EXTENSION
SCHOLAR NAME: _______________________________ UNID: __________________________

SHEI NAME: _______________________________________________________________________
DHEI NAME: _______________________________________________________________________
PROGRAM:_______________________________________________________________________
Per, Article VI (5) of CHED Memorandum Order (CMO) No. 3 s. 2016, as amended by CMO 36 s. 2016, CMO 4 s. 2017,
and CMO 2, s. 2018:
“Scholars are required to finish the degree within two (2) years of master’s and three
(3) years for doctoral degree, with a maximum of four (4) years allowed for the latter
for the purpose of further dissertation research. Meanwhile, scholars awarded with
Thesis/Dissertation grant are required to finish one (1) year. However, exceptions
may be allowed by the Commission based on the approved plan of study of the
scholar. The time limit shall be adjusted accordingly for scholars who avail of the
grant for ongoing master’s or doctoral degrees according to the units of coursework
and/or amount of research still to be undertaken.”
Consistent with the policies of my scholarship, I am requesting for an extension of my study plan, starting AY
__________, Term ___________ to AY __________, Term ___________. This covers _____ regular academic terms,
and _____ special or non-regular terms, and is equivalent to _____ months.
This is due to:

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Justification: Attach separate sheet if necessary.
______________________________________
Name and Signature of the Scholar and Date
Signed
J. PROSPERO E. DE VERA III, DPA
Chairman
Office of the Chairman
Commission on Higher Education
4/F, HEDC Building, C.P. Garcia Avenue
Diliman, Quezon City, 1101
Thru : ATTY. CINDERELLA FILIPINA BENITEZ-JARO

Officer-in-Charge, Office of the Executive Director
Director IV, Legal and Legislative Service
This is to inform you office that ____________________________, a student of (Degree Program)

____________________________ in (DHEI) ____________________________ under the CHED K to 12
Scholarships for Graduate Studies Local has been recommended to extend the study plan starting AY
__________, Term ___________ to AY __________, Term ___________. This covers _____ regular
academic terms, and _____ special or non-regular terms, and is equivalent to _____ months. The
extension is due to:
___________________________________________________________________________
___________________________________________________________________________
__________________________________________________________.
Furthermore, he/she is expected to finish the program on (Month) ___________ (Year) ___________.
For your consideration.
Noted by:
Name of Grants Management Officer: ______________________________________
Signature: ______________________________________
Date: ______________________________________
Name of Dean of College: ______________________________________
Signature: ______________________________________
Date: ______________________________________
J. PROSPERO E. DE VERA III, DPA
Chairman
Office of the Chairman
Commission on Higher Education
4/F, HEDC Building, C.P. Garcia Avenue
Diliman, Quezon City, 1101
Thru : ATTY. CINDERELLA FILIPINA BENITEZ-JARO

Officer-in-Charge, Office of the Executive Director
Director IV, Legal and Legislative Service
This is to inform you office that ____________________________, a student of (Degree Program)

____________________________ in (DHEI) ____________________________ under the CHED K to 12
Scholarships for Graduate Studies Local has been recommended to extend the study plan starting AY
__________, Term ___________ to AY __________, Term ___________. This covers _____ regular
academic terms, and _____ special or non-regular terms, and is equivalent to _____ months. This is due
to:
___________________________________________________________________________
___________________________________________________________________________
__________________________________________________________________.
This is to further certify that the service obligation of the scholar shall likewise be adjusted in proportion
to the extended period as stated above and in accordance with the scholar’s agreement with (SHEI)
_________________________________.
For your consideration.
Noted by:
Name of SHEI Coordinator: ______________________________________
Signature: ______________________________________
Date: ______________________________________
Name and Position of Authorized Representative:

______________________________________
Signature: ______________________________________
Date: ______________________________________

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SCHOLARSHIPS FOR GRADUATE STUDIES - LOCAL

REQUEST FOR EXTENSION

SCHOLAR NAME: _____ UNID:

This is due to:

Thru : ATTY. CINDERELLA FILIPINA BENITEZ-JARO

This is to inform you office that ____________________________, a student of (Degree Program)

For your consideration.

Name of Grants Management Officer: ______________________________________

Name of Dean of College: ______________________________________

Thru : ATTY. CINDERELLA FILIPINA BENITEZ-JARO

This is to inform you office that ____________________________, a student of (Degree Program)

For your consideration.

Name of SHEI Coordinator: ______________________________________

Name and Position of Authorized Representative:

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