Republic of the Philippines

PROVINCE OF PANGASINAN
OFFICE OF THE GOVERNOR Lingayen

PROVINCIAL SCHOLARSHIP PROGRAM (PSP)

POLICIES AND GUIDELINES FOR ACADEMIC SCHOLARS A.Y. 2021-2022
ARTICLE I
The Scholarship Offering
Section 1. General Description. The Provincial Scholarship Program (PSP) consists of financial assistance from the Provincial Government of Pangasinan for
the college education of financially-challenged but deserving graduating high school students.
Section 2. College Education, what it consists of. College education consists of completion of work, leading to any four-year or five-year Bachelor's degree
in any government recognized institution of higher leaming in the country.
Section 3. Financial Assistance, what it consists of. The amount of ten thousand pesos (P 10,000. 00) every term or semester, i.e., twice every academic
year, shall be given as financial assistance to the scholar. If the receiving school adopts a trimester program, the assistance is given at the first and the
third trimester. The basis of computation would be the General Weighted Average (GWA) of the first trimester and the sum of the GWA of the second and
third trimesters. Section 4. Standard for maintaining scholarship benefits.
Par. a.) Every scholar, must, in every semester of schooling, maintain (1) a full, normal load. Full normal load is the required number of
units to be enrolled by the scholar every semester as provided for by his/her school's course curriculum; (2) a GWA of eighty-
five percent (85%), with no grade below eighty percent (80%) in all academic and non-academic subjects.
Par. b.) In highly technical courses like Engineering, Architecture, and Accountancy, a GWA of eighty-two percent (82%), with no failing grade
in any subject, shall suffice in order to be entitled to the same scholarship benefits for the ensuing semester. Par. c.) Failure to meet the
foregoing standards for any reason terminates the scholarship assistance.
Section 5. Effects of other scholarship grants/ assistance.
Par. a.) The scholar who is able to eam academic scholarship or some other kind of educational benefits or privileges from the school itself,
or other private sources, shall still continue to receive financial assistance from the provincial government of Pangasinan. Where
the scholar is a recipient of the Free Tertiary Education benefits for State Colleges and Universities, he/she shall continue to receive
the scholarship assistance.
Par. b.) The scholar shall be disqualified to receive scholarship assistance, if he/she receives from the government another scholarship
assistance other than the Free Tertiary Education package in which case the scholar will have to choose betwee the PSP Academic
Scholarship or the scholarship coming from another government agency.
Par.c.) When a scholarship slot is vacated or waived, the PSP Management, Evaluation and Excellence Committee reserves the right to give it
to the applicant who is next in rank, based on the qualification standard. This applies to First Year scholars only.

ARTICLE Il
The Selection Criteria
Section 1. Qualified Applicants. The following can apply for the scholarship assistance:
Par a.) He/She should have a General Weighted Average (GWA) of eighty-five percent (85%) or higher.
Par b.) He/She should be a graduating Senior High School student of a recognized secondary school by the Department of Educatior Par c.)
He/She should belong to an indigent family as indicated by a Social Case Study Report from the DSWD.
Par d.) He/She should present a certificate of good moral character (PSP Form 2).
Par e.) He/She should present a medical certificate attesting to his/her good health.

ARTICLE Ill
Forfeiture of Benefit
Section 1. The scholar will lose his/her scholarship in any of the following:
Par. a.) When he/she fails to meet the grade requirement.
Par. b.) When he/she fails to enroll during the term or semester he/she is qualified.
Par. c.) When he/she, for any reason, stops schooling for one (1) term or one (1) semester.
Par. d.) When he/she fails to submit his/her grade requirements for one (1) term or one (1) semester
Par. e.) When he/she avails of another government scholarship assistance other than the Free Tertiary Education package.
Section 2. Exemption. A scholar who is disqualified to pursue highly competitive quota courses but has passed the maintaining grade Requirement of
the Provincial Scholarship Program (PSP) may shift to a related course in the same school, subject however to the Provincial Scholarship
Program Management, Evaluation and Excellence Committee (PSPMEEC's) review and approval.

ARTICLE IV
Submission of Application Requirements
Section 1. All applicants should comply with the one-time submission of complete scholarship application requirements either through
email: [email protected] or personally at the 1 st Floor Capitol Building, Lingayen, Pangasinan.
Section 2. Deadline of submission of complete scholarship application requirements for A.Y. 2021-2022 is on July 20, 2021.

ARTICLE V
Qualification Standard
Section 1. For A.Y. 2021-2022, due to the challenges of the pandemic, the selection for the two hundred ten (210) available slots will be base on the
following formula:

Note: PSP Academic Scholarship Application Form may be reproduced. Page 1 of 4 (April 2021)
 Population of Municipality/ City Total No. of Scholarship No. of slots
x Slots Available per Municipality/City
Grand Total No. of Population of Pangasinan in 2015
PSP Form No. 1
REPUBLIC OF THE
PHILIPPINES
PROVINCE OF
PANGASINAN
Lingayen

PSP ACADEMIC SCHOLARSHIP APPLICATION FORM

I wish to apply for college scholarship assistance and enroll at

(Name of school and address)

for the course effective Academic Year 2021-2022.

In support to my application, attached are the following documents:

1. Senior High School Fourth (Final) Grading Report Card with General Weighted Average (GWA) of 85% or higher (Certified
Photocopy by the Class Adviser)
2. Regular Medical Certificate from a licensed physician (Original Copy)
3. Social Case Study Report from the Municipal/City Social Welfare & Development Office(Original Copy)
4. Certificate of Scholarship Eligibility/ Good Moral Character (PSP Form No. 2)
5. Individual Information Sheet (PSP Form No. 3) with recent picture. (Taken within the last six (6) Months)

I hereby authorize the Provincial Scholarship Program Management, Evaluation and Excellence Committe( (PSPMEEC) or its
duly authorized representative, to investigate alt facts conceming my skills, habits, character, background and sucl other information
pertinent to my qualifications.

I understand that any misrepresentation, falsification or any omission of such fact, of whatever nature, required by this
application shall be considered a sufficient cause for denial of my application or termination of my scholarship privileges if alread' granted.

If accepted, I promise to abide by the rules and regulations, as embodied in the provisions of the Guidelines for PSP for
Academically Highly Competent College Students, which I have read and fully understood

(Applicant's Signature over Printed Name)

(Name and Address of School Graduated)

PSP Form No. 2

CERTIFICATE OF SCHOLARSHIP ELIGIBILITY

This is to certify thatis a candidate for graduation

(Name of applicant) from on

(Name of school and address) (Date of graduation) under the and meets all the requirements for
graduation.

(Academic Track/ Strand)

This is to certify further that he/she is of good moral character. He/ She is a recipient of the following academic and non-academic awards and
citations:

Note: PSP Academic Scholarship Application Form may be reproduced. Page 2 of 4 (April 2021)
 Award Received Level
Date
Title of Competition (Champion, Runner-Up (Municipal, Provincial,
(mm/dd/yy)
etc. National, etc.
1

3
4

5
TOTAL NO. OF GRADUATING SENIOR HIGH SCHOOL STUDENTS:

ATTESTED:

(Signature over Printed Name)

Class Adviser of Applicant

Date
PSP Form No. 3

INDIVIDUAL INFORMATION RECORD Please paste your 2x2

photo here
(Taken within the last six
months)

Name: Age:
Gender:

Directions: Give what is being called for as accurately and honestly as you can. Any misrepresentation may disqualify you for the scholarship. PART Ill
should be accomplished with the help of your parents or guardians.

PART I
1. Date of Birth (mm/dd/year) Place of Birth

2. Present Address

3. Contact Number/s:

4. No. of years of stay in the present address

PART Il
1. Name and address of secondary school

2.
3.
4.
5.
6.
PART Ill
1. Father's Name Occupation

Gross Income per month

Amount of Income Tax paid for previous year

2. Mother's Name Occupation

Gross Income per month

Amount of Income Tax paid for previous year

3. Guardian's Name (if applicable) Occupation

Note: PSP Academic Scholarship Application Form may be reproduced. Page 3 of 4 (April 2021)
 Gross Income per month

Amount of Income Tax paid for previous year

4. What do you like to be someday?

What does your father like you to be?

What does your mother like you to be?

What do your teachers like you to be?

What do your friends like you to be?

5. How many brothers and sisters do you have?

How many are studying?

Elementary: Junior High School: Senior High School College:

6. What other means of income does your family have aside from those mentioned in questions 1 and 2?
Please list them below:
Other Sources of Income Monthly Income

7. In at least 50 words, state your reason for applying for this college scholarship.

I HEREBY CERTIFY that the answers to the foregoing

are true and correct.

(Applicant's signature above printed name)

(Date)
ATTESTED:

(Parent's/Guardian's signature above printed name)

(Date)

Note: PSP Academic Scholarship Application Form may be reproduced. Page 4 of 4 (April 2021)