793, 6/F Unit 6B8, Victoria Station 1, EDSA, GMA Kamuning, Diliman, Quezon City, Philippines

PHILIPPINE SOCIETY OF AGRICULTURAL ENGINEERS, (PSAE), INC.

793, 6/F Unit 6B8, Victoria Station 1, EDSA, GMA Kamuning, Diliman, Quezon City, Philippines

Phone-Fax No.: (632) 920-4071Email:

Website:

OUTSTANDING AGRICULTURAL ENGINEER OF THE YEAR AWARD

SUMMARY OF REQUIREMENTS TO BE SUBMITTED

( ) Endorsement and nomination letter signed by the PSAE Regional President

( ) PSAE Outstanding AE Nomination Form

( ) PSAE Regional Chapter board resolution endorsing the nominees signed by the Board of Directors/Trustees or by the Secretary and attested to by the President.

( ) Certified true copy of valid PRC license

( ) Certificate of Membership of Good Standing issued by the PSAE Regional Chapter President.

( ) Certificate from the office, if employed, of no administrative, criminal case. For self- employed, affidavit of no pending case or not have been convicted of a final judgement by a court.

( ) Curriculum Vitae

( ) Current NBI clearance for all nominees and additional Ombudsman clearance for government employees/officials

( ) Attachments like:

• Photocopy of certificates of training/seminars/conferences/conventions
• Photocopy of Diploma
• Photocopy of special orders
• Highlights of technical papers
• Certificate of employment
• Other pertinent documents

LETTER OF ENDORSEMENT

AND NOMINATION

This is to endorse and nominate ______of ______, with address at ______as one of our nominees for the Outstanding Agricultural Engineer in the field of ______.

(State why he/she deserved to become an Outstanding AE) ______.

This endorsement and nomination is being issued this ______day of ______, 201__, at ______.

Endorsed and nominated by:

______

(Signature over Printed Name)

PSAE Region ____ President

Date: ______

Contact Number: ______

NOMINATIONFORM

( ) OUTSTANDING AGRICULTURAL ENGINEER OF THE YEAR

Field: ______

( ) MARAMBA AWARD

Name of Nominee :
(maybe reprinted to accommodate additional space requirement)
I. Identify and explain the potential impact/s or actual benefit/s of the three (3) most significant accomplishments/contributions of the nominee in agricultural engineering for the past three (3) years or 7 years for Maramba Award.
II.In not more than five sentences each, explain how the nominee performed using the following indicators:

1. Professional Competence (10%)

1. Integrity (5%)

1. Professionalism (5%)

1. Training (5%)

1. Experience (5%)

III.In not more than five sentences each, explain how the nominee meaningfully participated to PSAE activities:

1. Leadership (10%)

1. Activities/Services Done (10%)

1. Conferences, seminars, convention attended (10%)

IV.In not more than five sentences each; explain how the nominee significantly contributed to the advancement of Agricultural Engineering profession.

1. Research/production/extension/management of AE projects (25%)

-Describing the nature of project, highlights of the results and output, outcome and impact, involvement and extent of involvement of the nominee on the project and timeframe of the project.

1. Awards and recognition as AE (5%)

V.In not more than five sentences each; explain how the nominee significantly contributed to the effective discharge of the profession’s social responsibility through a meaningful contribution/participation in socio-civic related activities.

1. Involvement in civic organization (5%)

1. Community and Public Citations (5%)

I hereby certify to the truth of the above items.

______

Signature over printed name

Nominating person

______

Designation/Office

______
Date

Board Resolution No. ___

Series of 201__

RESOLUTION FOR NOMINATING ENGR. ______FOR THE PSAE OUTSTANDING AGRICULTURAL ENGINEER AWARD

WHEREAS, the Philippine Society of Agricultural Engineers (PSAE) Regional Chapter ___ Board of Trustees, during its meeting held on the ______day of ______at the ______decided to nominate ______for the Outstanding Agricultural Engineer of the Year in the field of ______;

WHEREAS, the PSAE Board of Trustees have evaluated his/her credentials accomplishments and found to have excelled in agricultural engineering profession and had a significant contributionto the country;

NOW THEREFORE, THE PSAERegional Chapter ___ DO HEREBY RESOLVE, as it is hereby resolved that ______will be nominated to the National PSAE selection of Outstanding Agricultural Engineer of the Year.

UNANIMOUSLY APPROVED during the PSAE Regional Chapter ____’s BOT meeting on the _____ day of ______at the ______.

Signed this _____ of ______at the ______.

Prepared by:

______

Secretary

Attested by:

______

President

CERTIFICATION

OF NO PENDING CASE/

NON-CONVICTION OF ANY OFFENSE

This is to certify that I, ______,

(complete name of applicant)

Filipino citizen, of legal age, ______, and a resident of

(civil status)

______, have no pending

(complete address)

administrative and/or criminal case before any court/authorized body. I, further, certify that I have never been found guilty/convicted of any administrative offense and/or crime.

I am executing this Certification in support of my application with the PSAE Outstanding AE Award. I understand that any misrepresentation as to the truth of the foregoing shall cause the disapproval of my application and/or outright revocation of my PAE license with PRC without prejudice to the filing ofadministrative and/or criminal case/s against me.

Done this ______day of ______, 20______.

______

Signature over full printed name of applicant

CERTIFICATION

OF MEMBERSHIP OF GOOD STANDING

This is to certify that ______has been a member of the Philippine Society of Agricultural Engineers Regional Chapter ______since ______. He/She has been an active member and of good standing.

This certification is issued upon the request of ______to support his/her nomination for the Outstanding Agricultural Engineer (or Maramba) Award.

Certified by:

______

(Signature over printed name)

PSAE Regional Chapter ____ President

Date: ______

Contact Number: ______

CURRICULUM VITAE

Date: ______

1. Personal Data

NAME:
POSITION, OFFICE
AND ADDRESS :
HOME ADDRESS:
CONTACT No.: / E-MAIL ADDRESS:
CIVIL STATUS: / PRC LICENSE No.:
DATE OF BIRTH: / PLACE OF BIRTH:
NAME OF SPOUSE:
NAME OF CHILDREN:
NAME OF PARENTS / Father:
Mother:

1. Educational Background

Degree / School/College/University / Inclusive Date of attendance / Honors Received/ Remarks

1. Eligibilities

Career Service/ RA 1080 (Board/ Bar) Under Special Laws/ CESE/ CSEE / Rating / Date of Examination/ Conferment / Place of Examination/
Conferment / Remarks

IV. Work Experiences

Position / Agency/Office and Address / Inclusive Dates

V. Other Designations/Special Assignments

Position/Designation / Major Function/s / Inclusive Dates

VI. Awards Received

Title of Award / Event/Date Received / Award-giving Body

VII. Trainings Attended:

Title of Training / Inclusive Dates / Venue / No. of Hours / Conducted By

VIII. Publication/Papers Presented

(Title, Publication, Address, Date/Title, Event, Venue, Date)

IX. Membership in Organization

(Name of Organization, Address, Contact No., Position held, Inclusive Date)

X. Significant Accomplishments and Other Notable Information

(Please provide details)

______

Signature over Printed Name

CTC No ______

Issued on ______

at ______

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