Commission on Higher Education
                                                               Office of Student Services
                                                       S tu de nt As s i sta nce an d Ser vi c es Di vi si o n
                                                  3        H.E.D.C. Building, C.P. Garcia St., UP Diliman
                                                                          Quezon City
                                                                      Tel #: (02)441-1220

                                   Overseas Filipino Workers One-Stop Processing Center
                                         (formerly Philippine Seafarers’ One-Stop Processing Center)

                                               Title: APPLICATION FORM FOR CERTIFICATION, AUTHENTICATION AND
             SASD FORM                                 VERIFICATION (CAV) (SASD FORM - 1)
   (for OFWOSPC use only)
                                               Revision No.: 0                         Checked by: DSAS
                   Page 1/1                    Revision Date: September 11, 2009       Issued by: OSS

      Name of Applicant

                                              Age:_____        Gender:   Male          Female

       Present Address:
   Provincial Address (if                     _________________________________________________________________
           any):                              _______________________________________________________________

      Contact Numbers:                        ________________________________________________________________
              Birth Date:                     __________________ BirthPlace: ________________________________

         Name of School
         Graduated from:

        School Address:                       Course/s         _______________________

      Purpose for applying:                       Sea based (SRC/SIRB)               Others, Please specify _______________

                                                  Land based (DFA “red ribbon”)

                                               How many copies? _____________

Enclosures (please check upon presentation of the original copy):
    1.          Official Transcript of Records 3.               Certification
    2.          Diploma                        4.               Clinical Experience for BSN     Applicant’ Signature or Authorized
                                                                                                    Representative Signature
                                                                                                 (Printed Name Over Signature)
Date Applied: ____________________________

(This portion to be filled-up by CHED-OSS staff)
Application                                                Remarks:
Received by:

JBAG/c:/barry/PSOC Matters/CAVformsmple.doc

   1.   Accomplished Application form (available at and at the Office of Students Services (OSS))
   2.   Two (2) sets of photocopies of Transcript of Records (T.O.R)
   3.   Two (2) sets of photocopies of Diploma
   4.   Certification from Higher Education Institution (HEI)

Schedule of the Availability of Service:
      Monday to Friday
      8:00 am to 5:00 pm

        Php 40.00 per copy

Total/Maximum Duration of Process:
       Fifteen (15) Days


   1. Files the application to the Student Assistant and Service Division (SASD) Staff, Office of Student Services

   2. Pays the Fee to the Cashier.

   3. Submits the accomplished application form with the attached school credentials and official receipt to the
      SASD Staff and receives claim stub.

   4. Follows-up thru phone to OSS.

            o    If OFW (Sea-based), Picks – up the C.A.V. and documents at the OSS

            o    If OFW (Land-based), follows-up with OSS the Control No. and Houseway Bill and date of release
                 from DFA

                         Picks-up the CAV and documents with red ribbon upon payment to DFA.