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CAV Application Form

DepEd application form for CAV

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DEPARTMENT OF EDUCATION
REGION III
Matalino St., D.M. Government Center, Maimpis, City of San Fernando (P)
Website: www.deped.gov.ph/region-iii  Email: region3@deped.gov.ph
Tel: (045) 5988580 - 89

ANNEX O
CAV FORM 15 – CAV APPLICATION FORM
Control No.:
Date of Application

NAME OF LEARNER:
DATE OF BIRTH:
PLACE OF BIRTH:
PRESENT ADDRESS:
CONTACT NO.:
NAME OF SCHOOL:
ADDRESS OF SCHOOL

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date.

CAV APPLICATION FORM
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PURPOSE (Please check any of the following):
☐ EMPLOYMENT ABROAD
☐ FIANCÈ VISA
☐ STUDENT VISA
☐ SEAMAN’S BOOK/SRC
☐ TOURIST VISA
☐ DESCENDANT’S VISA
☐ MIGRATION ABROAD
☐ REIMBURSEMENT OF EDUCATIONAL
ALLOWANCE/ TUITION FEES OF
CHILDREN OF OFW’S
☐SUCH OTHER PURPOSE AS MAYBE REQUIRED BY THE DFA
Signature Over Printed Name
(Applicant/Representative)
(TO BE FILLED-UP BY THE REGIONAL OFFICE)
Requirements
1.
2.
3.
4.
5.

Graduates
Public
Private
☐
☐
☐
☐
☐
☐
☐
☐

Undergraduates
Public
Private
☐
☐

Student Permanent Record (Form 137)
Diploma
Certificate of Completion/Graduation
☐
☐
Special Order
Certificate of Accreditation (for PAASCU
Accredited Schools)
6. Transmittal
☐
☐
☐
☐
7. ALS A&E / PEPT
☐
a. Certification from BEA
☐
☐
b. Rating
☐
☐
c. Certification from Division Office
☐
☐
8. Passport Size Picture (2 pcs.)
☐
☐
9. Documentary Stamp
☐
☐
10. Authorization Letter/ SPA/ I.D.
11. Note: If the applicant could not make it personally, a letter authorizing the bearer
should be presented to the CAV processor.
Original and 2 photocopies of the Requirements
 
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