Legal Name of Applicant

(Name on Birth Certificate)

Last Name

First Name

Middle Name
Recent 1x1 Photo of Applicant
Please write your name at the back of the photo.

ATENEO DE MANILA UNIVERSITY

LOYOLA SCHOOLS
Office of Admission and Aid

SCHOLARSHIP/FINANCIAL AID QUESTIONNAIRE

NOTE: This questionnaire should be accomplished by the parents of the applicant. It must be answered carefully and completely. Applications without the required documents or with incomplete information will not be processed. Parents may be called for interview for clarification of data given. All given information will be kept confidential. PLEASE ATTACH TO THIS FORM THE FOLLOWING REQUIREMENTS IN PROPER SEQUENCE: 1. Parents detailed and well-written personal letter about the familys financial situation and the urgent need for financial assistance 2. Two signed & sealed scholarship recommendation forms 3. For each presently employed parent and unmarried sibling of student residing with the family, submit the following: A. Certificate of Employment & Compensation (including bonuses, commissions, and allowances). OFWs must submit copy of employment contract B. Annual Income Tax Return or Certificate of Compensation Payment/Tax Withheld for the previous year. Please indicate in your personal letter if exempted from filing an ITR or reason for non-filing. C. Photocopy of pay slip for the last 3 months 4. If parents are self-employed/own a business or home industry, submit the following: A. Detailed description of the nature of work or business B. Income & expense financial statement for the previous year C. Annual Income Tax Return for the previous year. Please indicate in your personal letter if exempted from filing an ITR or reason for non-filing. D. If applicable, PHOTO of the building/establishment/place of business pasted/printed on a letter sized (8.5 x 11 inches) bond paper 5. If parents are retired or were retrenched within the past three years, submit a copy of the Certificate of Retirement or Separation with the amount of retirement/separation benefits received. 6. Photocopy of electric bill for the last 3 months. 7. If applicable, photocopy of credit card billing statements for the last 3 months. 8. Clear PHOTO of permanent residence (front view of the whole house) and kitchen. If residing in a building/condominium/apartment, please submit a photo of the whole building. Please paste/print on a letter sized (8.5 x 11 inches) bond paper. Scholarships at the Ateneo de Manila are extremely limited and are given primarily on the basis of financial need. In other words, the financial aid is a sharing of burden. Thus, the Ateneo expects that families will sacrificially carry that part of the burden of their childs education that lies within their means. In addition, the Ateneo does not give financial aid for food and living expenses of applicants. Application for financial aid does not, in any way, influence acceptance or non-acceptance into the Loyola Schools.

SCHOLARSHIP REQUEST
1. Scholarship Grants: 100TF 75TF 50TF 25TF Dorm Book Allowance Transportation Allowance 2. If he/she is not granted financial aid in the Loyola Schools, will he/she still come to the Ateneo? YES NO

PERSONAL INFORMATION
3. High School: 4. Home Address: (If in Ateneo Loyola Schools) Yr & Course

5. If student is from the province, check where he/she intends to live during his/her studies at the Ateneo: Ateneo Dorm Off-Campus Boarding House With a Relative Others, please specify 6. Mobile Phone No.: Email Address: 7. Fathers Name
Last First Middle

Tel. No.: Gender: Birthday:

Separated Widow / Widower

DATA ON PARENTS (OR GUARDIAN) Please check which is applicable Single Parent

Age (or if Deceased, when)

Mobile Phone No. Tel No. ______________ Email Address Highest educational attainment Occupation If self-employed, nature of work Amount of annual gross income If employed, name of company or employer Contact info/email: Position in the firm No. of years in the firm Annual gross salary in the firm Annual commissions, fees, or allowances If unemployed, please state when last employed and reason for unemployment now

8. Mothers Name
Last First Middle

Age (or if Deceased, when)

Mobile Phone No. Tel No. ______________ Email Address Highest educational attainment Occupation If self-employed, nature of work Amount of annual gross income If employed, name of company or employer Contact info/email: Position in the firm No. of years in the firm Annual gross salary in the firm Annual commissions, fees, or allowances If unemployed, please state when last employed and reason for unemployment now

FAMILY FINANCIAL STATUS

(Please complete these two columns, otherwise your application will be considered INCOMPLETE!) 9. GROSS INCOME (per year in PESOS) Annual Pay Father Mother Educational Benefits from Company Retirement Benefits/Separation Pay Profit on Business Profit/Rentals on Lands Rentals on Residence/Buildings Commissions Financial Support of Children Financial Support of Relatives Financial Support of Friends/Others Pension Others
TOTAL GROSS ANNUAL INCOME

FAMILY EXPENSES Monthly Expenses Food/Grocery House Rent/Amortization Electricity, Gas, Water Telephone, Cellphone Cable, Internet Transportation/School Bus School Allowance Helper/Driver Others (specify Sub-total x 12 months

DO NOT LEAVE BLANK WHEN APPLICABLE

Deposits Bank & Branch/ Company Latest Balance (with date)

Savings Account Checking Account Time Deposit Other Deposits/ Placements Foreign Currency Deposit Stocks Credit Card Bank Provider/s:

Yearly Expenses Clothing, Uniform Insurance, Plans Loan (Car, Education, House) Medicines/Check-up/Dental School Supplies School Tuition & Fees SSS/GSIS, Pag-Ibig Withholding Tax Others (specify ) Sub-total
TOTAL ANNUAL EXPENSES* * If the total for expenses is higher than total income, please explain in your letter how the deficit is covered.

10. Permanent Residence Location House Apartment Condominium Size of Lot House Floor Area in Sq. Meters Rented Owned Living with Relatives/Friends Free Housing provided by Company/Friends No. of floors No. of bedrooms No. of baths/toilets No. of helpers, drivers, etc. a. If rented, who is owner Contact No. how long in this place monthly rent b. If owned, name of owner relationship to applicant acquired when cost when acquired present market value amount of mortgage unpaid monthly mortgage payment 11. Do you have/own a business/home industry? What kind? When was business started? Capital invested No. of Employees Annual Net Profit

12. Other properties owned (residential, commercial, etc.) Description Location Size Acquired and/or use When

Acquisition Cost

Present Market Value

Yearly Net Income

13. Household Possessions

(DO NOT leave this blank.)

Qty.

Acquired When

Acquisition Cost

Balance to be Paid

Monthly Payment

Air-conditioners Cellular phone/s Component/Videoke iPod/MP3/MP4 Player Laptop/Tablet/Notebook Microwave/Oven Piano/Organ PC/Printer Refrigerators/freezers TV Sets VCD/DVD Washing Machine/Dryer 14. Cars & other motor vehicles owned or regularly used by the family:
Make/Yr/Model When Purchased Amt of Purchase Terms of Payment (Cash or Installment) If in installment, how much per year? Balance to be Paid Company/ Family Owned*

*If company owned, please attach the latest OR and CR.

OTHER FAMILY INFORMATION

15. Children no longer in school / who are employed: Name Age Civil Still Highest educational Status residing attainment and and no. of with you? school attended
dependents

Where employed
(Company and Location)
If unemployed, state reason.

Position in the Firm

Annual Gross Income

(Do not leave blank)

(Y/N)

16. Children still in school including applicant or not yet studying (eldest first):
Name Age Civil Status Grade/Year School Yearly Tuition & Fees of school Amt. covered by Scholarship Amt. covered by Parents

17. Other dependents living with the family 18. Name the persons (relatives, friends, etc.) who help with the family household and educational expenses and indicate duration and extent of financial support (for whom, how much per month?)

19. Did any of your children receive college scholarships in the past from the Ateneo de Manila? Please give names percentage of scholarship received, email address and cellphone number. 20. Did the applicant enjoy any form of financial aid in high school? YES: Year level/s NO

Legal Name of Applicant

(Name on Birth Certificate)

Last Name

First Name

Middle Name

21. Does the student have a part-time job? YES NO If yes, please indicate the type of job (e.g., tutoring, research assistant, call center agent, etc.) How many hours per week? How much does he/she earn in a month? 22. On the average, how much school allowance is budgeted for the student for a month? 23. a) Is the applicant enrolled under an education plan for his/her college studies? YES NO
If yes, please attach a copy of the educational contract or agreement of the applicant.

b) Will you be able to receive any tuition reimbursement from the plan company? YES NO
If yes, how much is the expected reimbursement for the current school year?

24. Are any of your family members under petition for immigration or have any pending visa application to another country (e.g., USA, Canada, etc.)? YES NO Does anyone have plans to travel outside the country within the next 2-3 years? YES NO If yes, please indicate who is leaving and reason for such travel:

25. Name two persons in your community (excluding relatives) or in the Ateneo de Manila University who know your family very well and whom the Committee may get in touch with for possible inquiry. (Do not leave this blank.) NAME ADDRESS CONTACT NUMBERS

We hereby certify that all the information given here is true and correct, and you are hereby authorized to verify the same through an official inquiry if needed. We understand that misrepresentation of information or withholding of information requested in this questionnaire will be considered sufficient reason for disapproval or cancellation of financial aid. We agree that if the student withdraws from the Loyola Schools for non-medical and/or non-academic reason, when he/she fully meets the required yearly QPI for retention, our family will reimburse the University with the total amount of financial aid received during the last semester (and Summer term, if applicable) the student is officially enrolled.

Students Signature

DATE

Fathers Signature

Mothers Signature

DO NOT WRITE BELOW THIS LINE

PAI HS: HA DECISION: A
5/2011

PEP MA

PMP EA

PTA SA W CONGIV: NO

SCHOLARSHIP RECOMMENDATION FORM ATENEO DE MANILA UNIVERSITY

LOYOLA SCHOOLS Office of Admission and Aid
INSTRUCTIONS
TO
THE

Legal Name
(Name in Birth Certificate)

Last

First

M.I.

School

Please write in ink.

APPLICANT: Write your name above. Give this form to the person who knows you well enough and who is presently holding a position of authority over you in your present school. You may choose your guidance counselor or one of your high school teachers (for freshman applicants) / one of your college professors (for transfer applicants) to recommend you. Supply him/her with an envelope.

TO THE PERSON RECOMMENDING: The person above is an applicant for Scholarship to the Ateneo de Manila University. The Committee on Admission and Aid will appreciate your opinion on the points stated below. Please make your judgment carefully and fill out the form completely as it will surely be used in the evaluation of financial need and merit of the applicant. After accomplishing the form, please place it in the envelope provided by the applicant, sign across the flap of the envelope, seal the envelope and return to the applicant. Unsealed and unsigned recommendations will not be accepted. Thank you.

GENERAL EVALUATION
1. How long and in what capacity have you known the applicant?

2.

What are his/her best traits as a student and/or as a leader?

3.

In what ways is he/she of service to the school and the community?

4. 5. 6.

Is the applicant a recipient of any academic grant, financial aid, or tuition discount in high school? Is the applicant applying to other government and private scholarship grants (e.g., DOST, other Foundations)? Describe briefly the familys financial situation. (DO NOT leave blank. Use back of form, if needed.)

OVERALL RECOMMENDATION
Please check.

____ Strongly recommended for: ____ Full Scholarship

(Please do not leave this part blank)

____ Partial Scholarship

____ Not recommended for scholarship.

Printed Name School Position Signature Department Tel. No.

Date

SCHOLARSHIP RECOMMENDATION FORM ATENEO DE MANILA UNIVERSITY

LOYOLA SCHOOLS Office of Admission and Aid
INSTRUCTIONS
TO
THE

Legal Name
(Name in Birth Certificate)

Last

First

M.I.

School

Please write in ink.

APPLICANT: Write your name above. Give this form to the person who knows you well enough and who is presently holding a position of authority over you in your present school. You may choose your guidance counselor or one of your high school teachers (for freshman applicants) / one of your college professors (for transfer applicants) to recommend you. Supply him/her with an envelope.

TO THE PERSON RECOMMENDING: The person above is an applicant for Scholarship to the Ateneo de Manila University. The Committee on Admission and Aid will appreciate your opinion on the points stated below. Please make your judgment carefully and fill out the form completely as it will surely be used in the evaluation of financial need and merit of the applicant. After accomplishing the form, please place it in the envelope provided by the applicant, sign across the flap of the envelope, seal the envelope and return to the applicant. Unsealed and unsigned recommendations will not be accepted. Thank you.

GENERAL EVALUATION
1. How long and in what capacity have you known the applicant?

2.

What are his/her best traits as a student and/or as a leader?

3.

In what ways is he/she of service to the school and the community?

4. 5. 6.

Is the applicant a recipient of any academic grant, financial aid, or tuition discount in high school? Is the applicant applying to other government and private scholarship grants (e.g., DOST, other Foundations)? Describe briefly the familys financial situation. (DO NOT leave blank. Use back of form, if needed.)

OVERALL RECOMMENDATION
Please check.

____ Strongly recommended for: ____ Full Scholarship

(Please do not leave this part blank)

____ Partial Scholarship

____ Not recommended for scholarship.

Printed Name School Position Signature Department Tel. No.

Date