CERTIFICATE OF CANDIDACY

I hereby announce my candidacy for the position of _________________________ in the

March 5, 2015 Election; and after having been sworn to in accordance with law, hereby state the
following:
Name:_______________________________

Stage name: ___________________

Family Name, First Name(s) Middle Name

Birthdate:______________________

Civil Status: ___________________

Month/Date/Year

Place of Residence:_____________________________________________________
Course and Year: ___________

Department: ____________

Length of residence in USC: ___________________

In Years/semesters

College: ____________

Current Academic Load: ________

As of 2nd semester AY 2014-2015 only

Political Party: _______________________________

Indicate Independent if running independently

Contact Number: ________________ Email: _______________________________

Authentic Social Media Accounts
Pursuant to Art 9 Sec 7a, all candidates shall declare all their social media accounts used to campaign for the purpose of eliciting votes upon submission
of Certificate of Candidacy. You may place in a separate sheet other social media accounts that may not be accommodated in the space provided

Facebook URL: ________________________________

Twitter: _________________________
Instagram: _______________________
Other Accounts: ______________________________________________________
Indicate the Media and the account URL.

Present Affiliations
University-based or community-based membership in any group or organization.

Organization

Position

Date of Membership

_________________________

_________________

__________________

_________________________

_________________

__________________

_________________________

_________________

__________________

I am a natural-born Filipino citizen. (For presidential and vice-presidential candidates)

I possess all the qualifications and none of the disqualifications for the office
I seek to be elected to.
I will support and defend the USC Constitution and will maintain the true
faith and allegiance thereto.
I assume voluntarily the obligation imposed by my oath, without mental
reservation or purpose of evasion.
I hereby certify that facts stated herein are true and correct to the best of my
knowledge.

_________________________________________
Signature of Candidate Above Printed Name
For inquiries, contact Comelec Chairperson Danica Blanche Fernandez at 0933 437 64 99 or email at
comelec.uscssc@gmail.com.

CERTIFICATION

This is to certify that ____________________________________, running as

_____________________, is a bona fide undergraduate/graduate student of the University
of San Carlos with an academic load of _______ units in the second semester of AY 2014-2015
and is not expected to graduate anytime until March 2016.

This certifies that the information stated above is accurate to the best of his/her knowledge.

_____________________________________
Signature of Dean/Chairperson Above Printed Name

For inquiries, contact Comelec Chairperson Danica Blanche Fernandez at 0933 437 64 99 or email at
comelec.uscssc@gmail.com.

------------------------------------------------------------------------------------------------------------Please neatly cut out this part. DO NOT SUBMIT THIS PART OF THE FORM. For your guidance only.

Checklist for Submission: (Article 8 Sections 2 and 3 of the 2014 USC-SSC Election Code)
Duly filled-up certificate of Candidacy,
Certification signed by the Candidates College Dean or Department Chairperson only,
Two (2x2) black and white or colored picture with white background,
Present ISMIS study load,
For incumbent officers in the Supreme Student Council, a letter of resignation signed
and approved by the SSC President or the highest ranking officer in the Council, and
Filing fee of One Hundred Pesos (P100.00) per candidate.
There will be a P50.00 penalty for every requirement submitted later than the deadline.

For inquiries, contact Comelec Chairperson Danica Blanche Fernandez at 0933 437 64 99 or email at
comelec.uscssc@gmail.com.