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A4 Gip Application Form

1. The document is an application form for the DOLE Government Internship Program (GIP) that collects personal information such as name, address, birthdate, education history, and contact details from applicants. 2. It asks applicants to describe their area of study and why they are interested in the internship program. 3. Applicants must certify that all information provided is accurate and that they understand the program guidelines before signing and submitting the form.

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Neil Dalanon
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906 views2 pages

A4 Gip Application Form

1. The document is an application form for the DOLE Government Internship Program (GIP) that collects personal information such as name, address, birthdate, education history, and contact details from applicants. 2. It asks applicants to describe their area of study and why they are interested in the internship program. 3. Applicants must certify that all information provided is accurate and that they understand the program guidelines before signing and submitting the form.

Uploaded by

Neil Dalanon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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DOLE GIP Form A

DOLE REGIONAL OFFICE No. V


Masbate Provincial Field Office
GOVERNMENT INTERNSHIP PROGRAM (GIP) APPLICATION FORM
INSTRUCTION TO APPLICANT: Please fill-out in three (3) copies all the required information in this form and attach additional documents, if necessary.

1. NAME OF APPLICANT:

Family Name First Name Middle Name


2. RESIDENTIAL ADDRESS:
ATTACHED 2 X 2 PHOTO WITH NAME

AND SIGNATURE TAKEN WITHIN THE

LAST THREE (3) MONTHS


Telephone No:

Mobile No:

Email Address:

3. PLACE OF BIRTH (City/Province)

4. DATE OF BIRTH (mm/dd/yyyy) AGE:

5. GENDER Male Female

6. CIVIL STATUS Single Married Widow/Widower

7. LBP ATM ACCOUNT NO.*

8. NAME OF GSIS INSURANCE BENEFICIARY**: RELATIONSHIP:

9. EDUCATIONAL ATTAINMENT
NAME OF SCHOOL INCLUSIVE DATES DEGREE OR DIPLOMA
FROM TO

CERTIFICATION: I certify that all information given in this application are complete and accurate to the best of my knowledge. I acknowledge
that I have completely read and understood the DOLE-GIP Guidelines as embodied in Administrative Order No. 436 Series of 2013.

DATE SIGNATURE OF APPLICANT


FOR DOLE RO/FO Use Only
Interviewed by and validated by:

______________________________________________
NAME and SIGNATURE

______________________________________________ _____________________
Position DATE
DOCUMENTS RECEIVED: (Pls. check)
1. DOLE GIP Form A (3 copies) 3. Birth or Baptismal/Marriage Certificate (3 copies)
2. Any of the following school records (3 copies) 4. Certificate of Indigency (Optional)
Transcript of Records/Form 137 5. ID No.: Date of Issue:
Certificate of Graduation in case of voc-tech or ALS graduates Place of Issue:
College or High School Diploma (3 copies)
* Payment of stipend/allowance shall be through Payment Center
** Interns will be covered by GSIS insurance
DOLE GIP Form B
A. PLEASE DESCRIBE YOUR CURRENT AREA OF STUDY

B. PLEASE TELL US WHY YOU ARE INTERESTED IN DOLE GIP

CERTIFICATION: I certify that all information given in this application are complete and
accurate to the best of my knowledge. I acknowledge that I have completely read and
understood the DOLE GIP Guidelines as embodied in Administrative Order No. 119 series of
2012

DATE: SIGNATURE OF APPLICANT (required):

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