Student Loan Application Form

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University of the Philippines Los Baños STUDENT LOAN BOARD PROGRAM (Revised October 14, 2005)

Application Number: Semester: Date Filed: STUDENT LOAN APPLICATION FORM 4

Year:

20

-

20

1. LOAN (For computation of OSA Loan Staff Only) Total Matriculation Fee (TMF) (100%) Amount of SLB Loan applied for (TMF X 0.8) Cash Payment upon Enrollment (TMF X 0.2) 2. STUDENT BORROWER (Please write legibly in print) I have the honor to apply for Student Loan from the University Student Loan Board Fund. For value received, I promise to pay the University the said amount plus interest on or before due date which is ________________________. Important: ____ New Applicant for SLB ____ Old Applicant (pls specify last semester of application)_____Semester _______ Name of Student: (Surname) Student / ID Number: College / Course / Classification Parent’s Name: Permanent Mailing Address: (House No./Street/Subd.) (Town) Contact Number (Student) Landline,

Cellphone No., /Email Address, if Any:

. . . . . . . . .Php . . . . . . . . .Php . . . . . . . . .Php

(First Name)

(MI)

Signature

(Barangay) (Province / City)

3. CERTIFICATION 3a. College Secretary The above-named student applying for SLB Loan is a bonafide student of this college.

College Secretary 3b. Co-Debtor (Parent/Relative)

Date

I am willing and capable of serving as co-debtor of the above-named student who is applying for SLB Loan. Name of Co-Debtor: Printed Name Relationship to Debtor (Pls. Check) Parent Relative Co-Debtor’s Complete Address: Contact Number (Co-Debtor) Landline, Cellphone No., /Email Address, if Any: 4. APPROVED / DISAPPROVED Director, OSA (Chairman, SLB) Rules / Requirements for SLB Loan 1. 2. 3. 4. 5. Maximum loan is 80% of total assessed fees at 3% rate of interest per semester. A co-debtor shall guarantee any loan application. Acceptable co-debtors are parents and relatives of the student (excerpts from the minutes of the 1201th Meeting of the Board of Regents,...
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