SA FORM 10

CERTIFICATE OF CANDIDACY
Columban College, Inc. Olongapo City Inter-Departmental Coordinating Council Academic Year __________
2x2 PICTURE

Please print all information legibly. Only complete and accomplished certificates of candidacy will be processed.
PERSONAL INFORMATION

Name: ___________________________________ Course: _________ Religion: ____________ DOB:

Age: _____ Sex: ____ Place of Birth:

Nationality: __________
CONTACT INFORMATION

Address: ___________________________________ ___________________________________ Contact No.: ___________________ Email Address: _________________

FAMILY BACKGROUND

Father: ____________________________

Occupation: _________________

Educational Attainment: ______________________ Mother: ____________________________ Occupation: _________________

Educational Attainment: ______________________ Siblings (Brothers/Sisters):

AFFILIATIONS: ORGANZATIONS (ON AND OFF-CAMPUS)

ORGANIZATION

POSITION

DATE(S)

EDUCATIONAL BACKGROUND

LEVEL Preparatory Elementary Secondary College/University

SCHOOL

DATES ATTENDED

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AWARDS & RECOGNITIONS (4th Year HS Present)

AWARD/RECOGNITION

DATE(S)

ENDORSEMENTS (COLLEGE DEAN & 2 FACULTIES)

The signatories of this endorsement certify that the individual mentioned above is of good moral character, good behavior, and of excellent academic standing in the college. He/she is capable of handling the duties and responsibilities that come with whatever position that he/she may be running for. As reputed figures in the academe, we hereby affix our signature, thus endorsing the student whose name appears above, as a candidate for an elected position in the IDCC.

_______________________ College Dean

SIGNATURE OVER PRINTED NAME

______________________ Faculty
SIGNATURE OVER PRINTED NAME

______________________ Faculty
SIGNATURE OVER PRINTED NAME

LETTER OF CANDIDACY

I, whose name appears above, as a bonafide student of Columban College, Inc., of good academic standing and good moral character, do hereby declare my candidacy for the position of ________________________________ under the Political Party _______________________. It is that I pledge not to clench for power, but for the desire to serve and lead my fellow students. I am running for this position on my own free will, and that I understand all the duties & responsibilities which it entails. I certify that the above information are true and correct to the best of my knowledge. I affix my signature this ______ day of the month of ________ in the year 2013.

____________________________
SIGNATURE OVER PRINTED NAME RIGHT THUMB MARK

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