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TDAP Application Form
BAR application form for Thesis/Dissertation Assistance Program
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Department of Agriculture
Bureau of Agricultural Research
RDMIC Bldg., Elliptical Rd. Cor. Visayas Ave., Diliman, Q.C. 1104
Phone Nos.: (632) 928-8624 & 928-8505 Fax: (632) 927-5691
Email: rd@bar.gov.ph Website: http//www.bar.gov.ph
Thesis/Dissertation Assistance Program (TDAP)
APPLICATION FORM
Instructions: Complete the application form and affix you signature where required. Place
NA where not applicable. Check appropriate box.
1. Name:
Surname
Given Name
Picture
2” x 2”
Middle Name
2. Office:
3. Station/Division:
4. Office Address:
Phone No.:
5. Home Address:
Phone No.:
Date of Birth:
6. Place of Birth:
Barangay/Municipality/City/Province
7. Sex:
Male
Female
Marital Status:
Day/Month/Year
Single
Widowed
Married
Separated
8. Assistance Applied for:
9. Field of Study:
(i.e. Agronomy, Soils, Economics, etc.)
10. University/College Enrolled in:
11. Address:
12. Present Position:
Division/Section:
13. Length of Government Service (No. of years):
Length of Service at the DA (No. of years):
No. of years in present position:
14. Nature of Appointment:
DOCUMENT NO.:
REVISION NO.:
BAR/QSF-D.02.01
00
REVISION DATE:
EFFECTIVITY DATE:
09 September 2005
TDAP APPLICATION FORM
Page 2 of 2
15. Educational Background:
(List chronologically starting with the most recent, use extra sheet when necessary.)
School/University
Date Graduated
Degree/Course
16. Work Experience:
(Begin with your more recent employer. Please use extra sheet when necessary.)
Employer/Address
Position Held
Job Description
Inclusive Dates
17. Brief description of duties and responsibilities of your present job:
I declare under penalties of perjury that the answers given above are true and correct to the
best of my knowledge and belief.
Signature of Applicant
ATTACHMENTS: 1. Endorsement of the application by the agency head 2. Approved Thesis/Dissertation outline
3. Research work plan approved by Adviser and agency head 4. Budgetary requirement approved by Adviser
and agency head (kindly give breakdown of the amount requested from BAR, personal expense, support from
mother agency, scholarship award, etc.) 5. Certificate of completion of academics units 6. Certificate of
passing the comprehensive exam 7. Certification as to whether or not the applicant has received any financial
support for the conduct of the thesis/dissertation (provide copies of award letters) duly signed by the applicant
and concurred by the head of mother agency/institution FOR DETAILS: Call (02) 920-0219.
DOCUMENT NO.:
REVISION NO.:
BAR/QSF-D.02.01
00
REVISION DATE:
EFFECTIVITY DATE:
09 September 2005
