APPLICATION FORM FOR ACCREDITATION
Name of Organization:_________________________________________________________
Address:____________________________________________________________________
Contact No.: ____________________ Email address (optional): ___________________
Date Organized: _________________ Sector/s Represented: _____________________
Purposes/Objectives: _________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Services that the organization provides or can participate in: ________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Registering Agency: Date Registered: ______________________
Securities and Exchange Commission (SEC)
Cooperative Development Authority (CDA)
Department of Labor and Employment (DOLE)
Department of Human Settlements and Urban Development (DHSUD), formerly the
Housing and Land Use Regulatory Board (HLURB)
National Commission on Indigenous Peoples (NCIP) *certification
Accrediting Agency (if any): Date Accredited: ____________________
Commission on Population and Development (POPCOM)
Department of Agriculture (DA)
Department of Public Works and Highways (DPWH)
Department of Social Welfare and Development (DSWD)
Department of Agriculture (DA)
Department of the Interior and Local Government (DILG)
Department of Labor and Employment (DOLE)
National Commission for Culture and the Arts (NCCA)
Presidential Commission for the Urban Poor (PCUP)
Philippine Drug Enforcement Agency (PDEA)
Department of Labor and Employment (DOLE)
Others (specify): ____________________________
Organizational Level:
Barangay-level
Chapter
Affiliate of a larger organization (identify organization): ________________________
Others (specify): ____________________________
Projects Implemented in the Municipality of Bautista
Year Project Cost Financing Beneficiaries Status
Source/Scheme Completed Ongoing
Depending on your organization’s technical area of expertise and scope of activity,
which Local Special Body are you most capable to be a member of?
Local Development Council
Local Health Board
Local School Board
Local Peace and Order Council
WE HEREBY CERTIFY to the correctness of the above information.
______________________ ______________________
President Secretary
TO THE APPLICANT
Kindly go through a self-assessment of the following requirements for your application. Please
do not submit the Application Form without performing the said self-assessment.
1 Letter of Application
2 Duly accomplished Application Form for Accreditation
3 Duly approved Board Resolution signifying intention for accreditation for the purpose of
representation in a local special body
4 Certificate of Registration or existing valid Certificate of Accreditation from any NGA (or in the
case of IPOs, certification issued by NCIP)
5 List of current Officers
ADDITIONAL REQUIREMENTS FOR CSOs IN OPERATION FOR AT LEAST ONE (1) YEAR
6 Minutes of the Annual Meetings of the immediately preceding year as certified by the
organization’s board secretary or Certification from the board secretary certifying the annual
meeting’s conduct, including the date, location, attendees, and agenda
7 Annual Accomplishment Report for the immediately preceding year
8 Financial Statement, at the minimum, signed by the executive officers of the organization, of
the immediately preceding year, and indicating therein other information such as revenue,
expenses and the source(s) of funds
