Republic of the Philippines

Department of Science and Technology

SCIENCE EDUCATION INSTITUTE

2024 SCHOLARSHIP AGREEMENT

DOST-SEI S&T UNDERGRADUATE SCHOLARSHIP

PARTY OF THE FIRST PART:

1ST & 2ND LEVELS, SCIENCE HERITAGE BUILDING,
ALBERT G. MARIÑO DOST CMPD., BICUTAN, TAGUIG CITY
Director III & OIC, SEI Address

PARTY OF THE SECOND PART:

191 A. MABINI ST., ZONE 3 BRGY. 30 MAYPAJO
CLARISSE FERRER CAPANZANA KALOOKAN CITY METRO MANILA
Awardee Address
191 A. MABINI ST., ZONE 3 BRGY. 30 MAYPAJO
RENATO P. CAPANZANA KALOOKAN CITY METRO MANILA
Parent/Legal Guardian Address

Pursuant to the implementation of the Science and Technology Scholarship Program under
 Merit  RA 7687
✔
_________________________________________________________________,
CLARISSE FERRER CAPANZANA ______
17 years old, ______________,
SINGLE Filipino
(Name) (Age) (Civil Status)

is hereby awarded the 2024 DOST-SEI S&T Undergraduate Scholarship to pursue a program of study leading to a degree in

BACHELOR OF SCIENCE IN PSYCHOLOGY

________________________________________________________________________________________________ at the
(Field of Study)

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES-MANILA

______________________________________________________________________ First
effective __________ Semester/Term
(University/College)
of Academic Year ___________________
2024-2025 subject to the terms and conditions of this Scholarship Agreement.

I. NATURE

The DOST-SEI S&T Undergraduate Scholarship award administered by the Department of Science and Technology-Science
Education Institute is for the pursuance of a priority program in the field of science, technology, engineering or mathematics
leading to a Bachelor of Science degree.

II. DURATION OF SCHOLARSHIP

The Scholarship shall be for a duration equivalent to the prescribed period of the program of study leading to a Bachelor of
Science degree, unless earlier terminated due to failure of the Party of the Second Part to comply with the terms of this
Scholarship Agreement

III. STUDY PLACEMENT

The Party of the Second Part shall enroll in any of the DOST-SEI identified institutions including the University of the
Philippines, State Universities and Colleges (SUC) or private higher education institutions that are recognized by the Commission
on Higher Education (CHED) as Centers of Excellence/Centers of Development (COE/COD) or with Level III accreditation from
the Federation of Accrediting Agencies of the Philippines (FAAP) for the priority S&T program he/she intends to enroll in.

IV. DUAL CITIZENSHIP

If the Party of the Second Part has a dual citizenship, he/she shall execute an undertaking which will be made an integral
part of this Agreement specifying that he/she elects Filipino citizenship upon reaching the age of majority. If he/she elects not
to be a Filipino citizen upon reaching the age of majority, he/she shall be made to refund in full, as outright payment, the
financial assistance granted to him/her including the 12% interest.

V. ENJOYMENT OF ANY OTHER GOVERNMENT SUPPORT / SCHOLARSHIP AWARD

If the Party of the Second Part shall enroll in an SUC, he/she may be exempt from paying tuition and other school fees as
provided under the Republic Act No. 10931 known as the “Universal Access to Quality Tertiary Education Act of 2017.” Moreover,
should he/she qualify for additional tertiary education subsidy (TES) under the same Act, he/she may be allowed to receive
these benefits.

The Party of the Second Part may be allowed to enjoy a private scholarship administered by the university/college he/she
is enrolled in simultaneously with the DOST-SEI S&T Undergraduate Scholarship, provided, that the terms of the private
scholarship do not interfere or are not in conflict with his/her contractual obligation/s with DOST-SEI.

If the Party of the Second Part decides, during the period of his/her DOST-SEI scholarship, to transfer to a private
scholarship, he/she shall be required to render service in the country as stipulated in Section X of this Agreement.

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VI. SCHOLARSHIP PRIVILEGES

The Party of the Second Part shall be entitled to receive financial assistance during the period of actual study to be disbursed
by the Party of the First Part, subject to the availability of funds for the purpose and to pertinent government accounting and
auditing rules, to wit:

A. During the regular academic year

1. School Fees – Tuition and other school fees based on Statement of Account/Bill/Official Receipt but not to exceed
P40,000.00 per academic year;
2. Learning Materials and/or Connectivity Allowance – For prescribed textbooks, essential school supplies,
load for the online connectivity, and other academic learning materials to be released as outright grant at
P10,000.00 per academic year;
3. Transportation Expenses – One actual economy class round trip per academic year from the permanent
residence of the scholars to the place of study outside his/her home province/region. (Reimbursement shall be
made at the start and end of the academic year only);
4. Clothing Allowance – The cost of Physical Education uniform for the First Semester, First Year only to be released
as an outright grant at P1,000.00;
5. Monthly Living Allowance – For the _______-month duration in each academic year at P8,000.00 per month;
6. Group Health and Accident Insurance;
7. Thesis Allowance – To be released as an outright grant at P10,000.00; and
8. Graduation Allowance.

B. During the summer/mid-year term, if required in the curriculum

1. Tuition and Other School fees not to exceed P10,000.00;

2. Learning Materials and/or Connectivity Allowance at P2,000.00, outright grant; and
3. Monthly Living allowance.

VII. SCHOLARSHIP OBLIGATIONS

A. Grade Requirement

The Party of the Second Part shall maintain the following grade requirements:
1. For the first year, an annual weighted average (2 semesters/3 trimesters/4 quarter terms) of 2.75 or better for
scholars enrolled in the University of the Philippines (UP) System and 2.5 or 85% or its equivalent or better for
scholars enrolled in all other colleges and universities and without failing grade in any academic subject for all
semesters/trimesters/quarter terms or summer/mid-year term.
2. For the second year, a semestral weighted average of 2.75 or better for scholars enrolled in the UP System and
2.5 or 85% or its equivalent or better for scholars enrolled in all other colleges and universities and without failing
grades in any academic subject for the semester/trimester/quarter or summer/mid-year term.
3. For the 3rd, 4th, and 5th years, passing grades in all academic subjects; provided that he/she takes the regular load
and completes the course within the prescribed period.

Should the scholar incur any academic deficiency, his/her academic performance shall be evaluated based on
guidelines approved by the Advisory Committee on Science and Technology Scholarships (ACSTS) or shall be elevated
to the ACSTS, through the National Technical and Selection Committee, for deliberation.

B. Academic Load

The Party of the Second Part shall enroll the required regular academic load for each school semester/trimester/quarter
term.

C. Reports

The Party of the Second Part shall submit the duly certified copy of the following reports:
1. Periodic Reports – At the beginning of the semester/trimester/quarter term or summer/midyear term –
registration form; and at the end of the semester/trimester/quarter term – grade for every academic subject taken.
2. Special Reports – Include curriculum or program of study; bank account number; travels out of the country;
Practical Training Program (PTP) reports; problems encountered; changes, if any, in the program of study, school,
residence address, civil status, and legal guardian; and such reports that may be required from time to time.
3. Final Report – On completion of the course, immediate and plans for employment/professional advancement,
and other requirements relevant to the DOST-SEI Scholarship Program submitted within one (1) month after
completion of the course.
4. Yearly Report – Corresponding to the 4th/5th/6th consecutive years after graduation (the maximum number of
the years of the scholarship) – employment status, professional advancement, civil status, mailing address and
others to be submitted not later than December 30 of each calendar year.

D. Practical Training

The Party of the Second Part shall undergo on-the-job training under the Practical Training Program in any of the
laboratories of the DOST and its agencies or at any of the research institutions/private companies during the
summer/mid-year immediately preceding his/her last year in college. The monthly stipend will be provided for the
duration, subject to the availability of funds for the purpose, the number of hours completed, and pertinent government
accounting and auditing rules.

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 E. Leave of Absence

The Party of the Second Part may be allowed an official leave of absence subject only to the following conditions:

1. The leave is highly justified, supported by pertinent documents;

2. A written permission from the university is granted;
3. The maximum duration of the leave is one (1) academic year and the expiration date shall be immediately before
the start of the ensuing semester;
4. Extending the leave beyond one year will result to the termination of scholarship; and
5. A report is submitted immediately upon his/her return to college. It will be used as basis for determining the
validity of the leave and the resumption of the scholarship or financial privileges.

F. Shifting of Program of Study/Transfer of School

The Party of the Second Part may be allowed to shift to another approved program and/or transfer school in meritorious
cases only subject to the condition that the program he/she is shifting to is included in the list of DOST-SEI priority
S&T programs and/or the school he/she is transferring to is a DOST-SEI identified institution. Shifting of
program/transfer of school may be done only once during the entire scholarship period and at the latest, by the First
Semester of the Third Year.

The Party of the Second Part shall sign an Amendatory Agreement for shifting of program/transfer of school which
shall be made an integral part hereof.

G. Physical Status and Moral Character

The Party of the Second Part shall maintain good physical condition and moral standing.

VIII. SUPERVISION

The Party of the Second Part shall be under the supervision and guidance of the Party of the First Part and shall comply
with all scholarship policies including those not indicated in this Agreement. He/she is not authorized to close his/her bank
account unless he/she has secured clearance from the Party of the First Part.

The Party of the First Part shall submit the name of the Party of the Second Part to partner government agencies such as
the National Bureau of Investigation for tracking purposes.

IX. TERMINATION OF SCHOLARSHIP

The Party of the First Part reserves the right to terminate this scholarship for failure of the Party of the Second Part to
maintain the grade requirement or to comply with any of the terms and conditions, including non-submission of periodic reports
for two (2) consecutive semesters of this Agreement effective as of the date indicated in a written notice to that effect to the
Party of the Second Part.

If the scholarship of the Party of the Second Part is terminated for failure to meet the academic requirement/s, he/she upon
completion of the degree program, shall either render service in the country equivalent to the length of time he/she enjoyed
the scholarship or refund the total financial assistance he/she received as a scholar with 12% interest.

X. SERVICE IN THE PHILIPPINES

The Party of the Second Part shall, immediately upon completion of his/her Bachelor of Science degree, render service in
the country on a full-time basis, preferably in his/her home region and along his/her field of specialization, for a minimum period
equivalent to the length of time that he/she enjoyed the scholarship.

The Party of the Second Part must be employed locally in the country while rendering his/her service obligation.

XI. TRAVEL ABROAD

The Party of the Second Part who shall travel out of the country while still under the scholarship or with service or financial
obligation may be issued temporary clearance to travel abroad upon submission of the required documents*; and Deed of
Undertaking or cash bond posted with DOST-SEI (for short term travel)/a surety bond posted with the Government Service
Insurance System (for travel of one year or longer). Failure to return to the country after the travel date will result in the
termination of the scholarship and a refund of the total financial assistance received plus 12% interest.

*Letter with details of the travel, supporting document for the reason of travel (when applicable)

XII. REFUND OF SCHOLARSHIP GRANT

The Party of the Second Part shall refund the total amount received in connection with this scholarship for any of the
following causes:

1. Breach of contract
2. Gross misconduct
3. Willful abandonment of the scholarship
4. Non-pursuance of DOST priority program or
5. Failure to render service as stipulated in Sections IX and X of this Agreement

Refund of the total financial assistance shall be with 12% interest.

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XIII. OBLIGATION OF THE PARENT/LEGAL GUARDIAN

________________________,
RENATO P. CAPANZANA the parent/legal guardian and representative of the Party of the Second Part in this
Scholarship Agreement hereby acknowledges, agrees, and binds himself/herself to:

1. Assume the civil liabilities that the Party of the Second Part may incur under this Agreement as well as the civil liabilities
that he/she may incur against other persons.
2. Shoulder the medical and other expenses in case of sickness, disability, or death of the Party of the Second Part.
3. Provide for other expenses of the Party of the Second Part which are not specifically mentioned in this Agreement;
4. Help and cooperate in the moral, spiritual, and mental development of the Party of the Second Part.
5. Assume the obligation to pay whatever amount the Party of the Second Part shall be required to refund if he/she
refuses to comply with the provisions of Section X or if this scholarship is terminated per the provisions of Sections IX
and XII above.

XIV. DATA PRIVACY

The Party of the Second Part hereby authorizes the DOST-SEI and its instrumentalities to collect, process, update, store,
use, transfer, archive, and delete his/her personal information, including those classified as sensitive personal information,
concerning this Scholarship. The Party of the Second Part further expresses consent to submit his/her personal data to DOST-
SEI after completion of his/her program of study pursuant to any research or evaluation study of DOST-SEI, including but not
limited to the TRACER Study of Scholars, Exit Survey, and scholarship program evaluation. This consent includes disclosure and
transfer of any personal information collected to authorized researchers and stakeholders of DOST-SEI who shall analyze the
personal data with other data/information gathered for any research and evaluation purposes to improve the implementation of
the scholarship programs.

The Party of the Second Part affirms his/her rights as data subject as provided for in Republic Act 10173, otherwise known
as the Data Privacy Act of 2012, its Implementing Rules and Regulations, and other applicable issuances of the National Privacy
Commission.

IN WITNESS HEREOF, the parties hereto sign this Scholarship Agreement on this ___________
6th day of ________________,
July
__________
2024 in the Municipality/City of _____________________________.
TAGUIG CITY

PARTY OF THE FIRST PART PARTY OF THE SECOND PART

ALBERT G. MARIÑO CLARISSE FERRER CAPANZANA

Director III & OIC, SEI Awardee

RENATO P. CAPANZANA
Parent/Guardian

PETER GERRY P. GAVINA PETER GERRY P. GAVINA

Witness Witness

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES)

_____________________________) S.S.

Before me, Notary Public for and in __________________, Philippines, this _____ day of _____________, __________
personally appeared:

Any government-issued ID Date and Place of

Name
/Passport No. Issuance
November 18, 2019
Party of the First Part: ALBERT G. MARIÑO 2014-001 BICUTAN, TAGUIG CITY
CLARISSE FERRER
Party of the Second Part: CAPANZANA
Aug. 15, 2022
Parent/Guardian RENATO P. CAPANZANA 5142-9015-7246-3750 N/A

known to me to be the same persons who executed the foregoing DOST-SEI Scholarship Agreement consisting of four (4) pages
including the page on which this acknowledgment is written, and they acknowledged to me that the same is their free and
voluntary act and deed.

IN WITNESS THEREOF, I have hereunto affixed my hand and notarial seal on the date and place above written.

___________________
Notary Public
Doc. No. ____;
Page No. ____;
Book No. ____;
Series of ____.