VIVANT FOUNDATION, INC.College Scholarship ProgramApplication Form_1 of 3

Instructions:

1. Fill out all fields on the digital copy (online) or a printed copy of the Application Form. (For the printed form, avoid erasures/corrections. You may obtain a digital copy of the Application Form through the Vivant Foundation, Inc. Facebook page or the Vivant Corporation website (www.vivant.com.ph)

2. For hard copies/print submissions, use only blue or black ballpen.

3. Submit pre-screening requirements not later than November 30, 2018 to either of the following:

E-mail: vvtfoundation@vivant.com.ph Walk-in: Benjamin Y. Chiu / Jasmine M. Perez

Vivant Foundation, Inc.8th floor, Ayala Life-FGU CenterCebu Business Park, Cebu City

Pre-screening requirements are as follows:a. Completely filled-out VFI College Scholarship Application Form;b. 300 to 500-word essay in VFI College Scholarship Sheet;c. Photocopy of Grade 12 Form 138 or Report Card, as applicable;d. Photocopy of Certificate of Good Moral or Honorable Dismissal, as applicable; ande. Photocopy of PSA-certified Birth Certificate.

PART A. PERSONAL INFORMATION

Complete name (Last, First, Middle)

Present address

Permanent address, if different from present

Age Birthdate (mm/dd/yy)Applicant’s number/s Parent’s number/sEmail address Facebook account

VIVANT FOUNDATION, INC.College Scholarship ProgramApplication Form_2 of 3

PART B. EDUCATIONAL BACKGROUND

School name Address Award/s received

Elementary

Junior HS

Senior HS

PART C. CHARACTER REFERENCES

List down two non-relative character references below.

Name Relationship Contact number

PART D. RSTF – VII INFORMATION

List all years that you joined the Regional Science and Technology Fair – VII. Start with the most recent. Use additional sheets if needed.

Year CategoryProject NameDescription of projectType ( ) individual ( ) team Placement ( ) 1st ( ) 2nd ( ) 3rd ( ) othersIf your project competed in the national level, indicate placement:

Year CategoryProject NameDescription of projectType ( ) individual ( ) team Placement ( ) 1st ( ) 2nd ( ) 3rd ( ) othersIf your project competed in the national level, indicate placement:

VIVANT FOUNDATION, INC.College Scholarship ProgramApplication Form_3 of 3

Year CategoryProject NameDescription of projectType ( ) individual ( ) team Placement ( ) 1st ( ) 2nd ( ) 3rd ( ) othersIf your project competed in the national level, indicate placement:

Year CategoryProject NameDescription of projectType ( ) individual ( ) team Placement ( ) 1st ( ) 2nd ( ) 3rd ( ) othersIf your project competed in the national level, indicate placement:

Where do you intend to pursue your college education? List down below top 3 choices, in order of priority.

1.2.3.

What degree program do you intend to take up in college? List down below top 3 choices, in order of priority.

1.2.3.

By submitting this Application Form and all other requirements to Vivant Foundation, Inc., I ensure that I completely read and understood the terms provided for in the Data Privacy Consent Form (Annex A) which I have signed. I also certify that all data contained herein and all documents submitted to VFI are true and correct. I understand that any misrepresentation will cause my indefinite disqualification to the VFI College Scholarship Program.

Applicant’s Full Name Applicant’s Signature Date Signed

For applicants under the age of 18:

Parent’s/Guardian’s Full Name Applicant’s Signature Date Signed