Republic of the Philippines
SCIENCE AND TECHNOLOGY INFORMATION INSTITUTE
                STII Building,DOST Complex, Bicutan, Taguig City
                                   LEARNING AND DEVELOPMENT NOMINATION FORM
   Division
   Course
 Fund Source
                                                            No. of Terms /
 School Year                                                 Semesters
                       Recommended Employee                                                       Position
                                         Checklist of Basic Requirements
                Must have rendered at least two (2) years of continuous service in the DOST System;
                Have obtained a performance rating of at least Very Satisfactory (VS) for the last two consecutive rating
                periods;
                Have no pending criminal or administrative case;
                Have no on-going financial obligation due to non-completion of a previous training as certified by HR
                Section or DOST-HRDP;
                The nominee’s present duties and responsibilities must be relevant to the field of study
                                     Recommended by:                             Approved by:
Employee                             Division Chief                              Director
Date:                                Date:                                       Date:
                                        SDC COMMITTEE RECOMMENDATION
                                                      Chairperson
              Member                                                                               Member
              Member                                                                               Member
              Member                                                                               Member
               Republic of the Philippines
               SCIENCE AND TECHNOLOGY INFORMATION INSTITUTE
               STII Building,DOST Complex, Bicutan, Taguig City
                               LEARNING AND DEVELOPMENT NOMINATION FORM
   Division                                                       Date submitted
    Title of
   Training
   Date of
                                                                  Training Provider
   Training
 Fund Source                                                      Amount
          Recommended Participant/s (in order of priority)                         Position
                                        Reason/s for Nomination
Recommended by:                 Recommending Approval:            Approved by:
                                ARLENE E. CENTENO                 RICHARD P. BURGOS
                                SDC Chairperson                   Director
Date:                           Date:                             Date: