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OSPC Form 4
Commission on Higher Education
O ffice of St udent D evelopment and Ser vices Ser vices
Inte rnational Stude nt Affairs Div ision
3R D H. E. D. C. Bu i l d i n g , C. P . Ga rci a Ave . , UP Di l i m a n
Qu e z o n Ci ty
T e l # : ( 0 2 ) 4 4 1 - 1 2 2 0
One-Stop Service Center for Overseas Filipino Workers (OSSCO)
(formerly Philippine Seafarers’ One-Stop Processing Center)
ISAD FORM
(for OSSCO use only)
Title: APPLICATION FORM FOR CERTIFICATION, AUTHENTICATION AND
VERIFICATION (CAV) (ISAD FORM - 1)
Revision No.: 2 Checked by: ISAD
Page 1/1 Revision Date: October 3, 2016 Issued by: OSDS
Name of Applicant
Age:_____ Gender: Male Female
Present Address:
Provincial Address
(if any):
________________________________________________________________
________________________________________________________________
Contact Numbers: ________________________________________________________________
________________________________
E-Mail Address
Birth Date: __________________ BirthPlace: ________________________________
Name of School
Graduated from:
School Address:
________________________________________________________________
Program: _______________________
Date
Graduated:
Purpose for applying:
Sea based (SRC/SIRB) Others, Please specify _______________
Land based (DFA “red ribbon”)
What country? __________________
How many copies of CAV? _____________
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-OSDS staff)
Application
Received by:
_____________________________
Remarks:
OSPC Form 4
BACK OF THE APPLICATION FORM
Requirements:
1. Accomplished Application form (available at www.ched.gov.ph, Office of Students Development
and Services (OSDS), or at the CHED Booth at the Philippine Overseas Employment
Administration, Blas Ople Building, EDSA corner Ortigas Avenue, Mandaluyong City)
2. Original copies of Transcript of Records and Diploma
3. Two (2) sets of photocopies of Transcript of Records (T.O.R)
4. Two (2) sets of photocopies of Diploma
5. Certification from Higher Education Institution (HEI)
Schedule of the Availability of Service:
Monday to Friday
8:00 am to 5:00 pm
Fees:
Php 80.00 per copy
Total/Maximum Duration of Process:
Fifteen (15) Days depending on the verification of CHED Regional Offices or concerned Higher Education
Institutions.
Instructions:
1. Files the application at the International Students Affairs Division (ISAD) Staff, Office of Student
Development and Services (OSDS) or CHED Booth at the Philippine Overseas Employment
Administration, Blas Ople Building, EDSA corner Ortigas Avenue, Mandaluyong City.
2. Pays the Fee to the Cashier or CHED authorized personnel at the CHED Booth, POEA.
3. Submits the accomplished application form with the attached school credentials to the ISAD Staff and
receives claim stub, provisional receipt or official receipt.
4. Follows-up thru phone to OSDS.
o If OFW (Sea-based), Picks – up the C.A.V. and documents at the OSDS.
o If OFW (Land-based), follows-up with OSDS the Control No. and Houseway Bill and date of
release to the Department of Foreign Affairs (DFA).
 Picks-up the CAV and documents with red ribbon upon application for authentication and
payment to DFA.

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Certification, authentication and verification (cav) application form

  • 1. OSPC Form 4 Commission on Higher Education O ffice of St udent D evelopment and Ser vices Ser vices Inte rnational Stude nt Affairs Div ision 3R D H. E. D. C. Bu i l d i n g , C. P . Ga rci a Ave . , UP Di l i m a n Qu e z o n Ci ty T e l # : ( 0 2 ) 4 4 1 - 1 2 2 0 One-Stop Service Center for Overseas Filipino Workers (OSSCO) (formerly Philippine Seafarers’ One-Stop Processing Center) ISAD FORM (for OSSCO use only) Title: APPLICATION FORM FOR CERTIFICATION, AUTHENTICATION AND VERIFICATION (CAV) (ISAD FORM - 1) Revision No.: 2 Checked by: ISAD Page 1/1 Revision Date: October 3, 2016 Issued by: OSDS Name of Applicant Age:_____ Gender: Male Female Present Address: Provincial Address (if any): ________________________________________________________________ ________________________________________________________________ Contact Numbers: ________________________________________________________________ ________________________________ E-Mail Address Birth Date: __________________ BirthPlace: ________________________________ Name of School Graduated from: School Address: ________________________________________________________________ Program: _______________________ Date Graduated: Purpose for applying: Sea based (SRC/SIRB) Others, Please specify _______________ Land based (DFA “red ribbon”) What country? __________________ How many copies of CAV? _____________ 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-OSDS staff) Application Received by: _____________________________ Remarks:
  • 2. OSPC Form 4 BACK OF THE APPLICATION FORM Requirements: 1. Accomplished Application form (available at www.ched.gov.ph, Office of Students Development and Services (OSDS), or at the CHED Booth at the Philippine Overseas Employment Administration, Blas Ople Building, EDSA corner Ortigas Avenue, Mandaluyong City) 2. Original copies of Transcript of Records and Diploma 3. Two (2) sets of photocopies of Transcript of Records (T.O.R) 4. Two (2) sets of photocopies of Diploma 5. Certification from Higher Education Institution (HEI) Schedule of the Availability of Service: Monday to Friday 8:00 am to 5:00 pm Fees: Php 80.00 per copy Total/Maximum Duration of Process: Fifteen (15) Days depending on the verification of CHED Regional Offices or concerned Higher Education Institutions. Instructions: 1. Files the application at the International Students Affairs Division (ISAD) Staff, Office of Student Development and Services (OSDS) or CHED Booth at the Philippine Overseas Employment Administration, Blas Ople Building, EDSA corner Ortigas Avenue, Mandaluyong City. 2. Pays the Fee to the Cashier or CHED authorized personnel at the CHED Booth, POEA. 3. Submits the accomplished application form with the attached school credentials to the ISAD Staff and receives claim stub, provisional receipt or official receipt. 4. Follows-up thru phone to OSDS. o If OFW (Sea-based), Picks – up the C.A.V. and documents at the OSDS. o If OFW (Land-based), follows-up with OSDS the Control No. and Houseway Bill and date of release to the Department of Foreign Affairs (DFA).  Picks-up the CAV and documents with red ribbon upon application for authentication and payment to DFA.