Instructions
1. For articles with inter-CU collaboration, each department/institute should submit a separate copy of this form.2. Applicant/s should senda scanned copy of this form (Form 4.1) and its attachments (Annexes 1, 2 and 3) in PDF format to using thisfilename format: IPA_CU_Department/Institute_Last Name, Initial of First Name_Journal_Article Title (up to the first five words). For example: IPA_UPD_NIP_Cruz, J_Optics Express_New Discovery in Holography.
Form 4.2 should be submitted in word file format while Form 4.3 should be submitted in hard copy.
3. This form should be submitted with the following documents:
OVPAA IPA Form 4.2 (Layman’s Summary)
OVPAA IPA Form 4.3 (Memorandum of Award for unit share, signed by the Department/ Institute head)
Annex 1 PDF copy of journal article
Annex 2 Scanned copy of the editorial board page of the journal
Annex 3.1, 3.2, 3.3... Copies of appointment paper of temporary UP personnel, Form 5 of student, contract of non-UP personnel, job order, or other proof of affiliation with the department/institute
Title of article:
Complete citation (title of article. name of journal. volume number, page numbers):
Name of UP author/s and affiliation/s (add rows as needed)
Name Constituent University
- ______
- ______
- ______
- ______
- ______
- ______
Total number of authors (including non-UP):
Name of journal:
Journal indexed in:
Web of Science Core Collection
Arts and Humanities Citation Index (AHCI)
Science Citation Index Expanded (SCIE)
Social Sciences Citation Index (SSCI)
Conference Proceedings Citation Index (CPCI)
SCOPUS
Journal Impact Factor (IF) at the time of publication of article: ______Year: ______
Date of Publication:
Name of Publisher:
Applicant 1
Name:Constituent University:
College:
Department/Institute:
Rank/Position:
Type of UP affiliation
UP Personnel
Faculty
Research Faculty
REPS
Admin Staff
UP-affiliated
Student
Project Personnel
Status of appointment:
Permanent
Temporary
UP-contractual
Non-UP contractual
Bank account details (for UP personnel):
Name of bank (government depository bank):
Branch:
Account number:
Contact details:
Telephone number:
Mobile number:
E-mail address:
Signature of applicant:
Applicant 2
Name:Constituent University:
College:
Department/Institute:
Rank/Position:
Type of UP affiliation
UP Personnel
Faculty
Research Faculty
REPS
Admin Staff
UP-affiliated
Student
Project Personnel
Status of appointment:
Permanent
Temporary
UP-contractual
Non-UP contractual
Bank account details (for UP personnel):
Name of bank (government depository bank):
Branch:
Account number:
Contact details:
Telephone number:
Mobile number:
E-mail address:
Signature of applicant:
Applicant 3
Name:Constituent University:
College:
Department/Institute:
Rank/Position:
Type of UP affiliation
UP Personnel
Faculty
Research Faculty
REPS
Admin Staff
UP-affiliated
Student
Project Personnel
Status of appointment:
Permanent
Temporary
UP-contractual
Non-UP contractual
Bank account details (for UP personnel):
Name of bank (government depository bank):
Branch:
Account number:
Contact details:
Telephone number:
Mobile number:
E-mail address:
Signature of applicant:
Applicant 4
Name:Constituent University:
College:
Department/Institute:
Rank/Position:
Type of UP Affiliate
UP Personnel
Faculty
Research Faculty
REPS
Admin Staff
UP-affiliated
Student
Project Personnel
Status of appointment:
Permanent
Temporary
UP-contractual
Non-UP contractual
Bank account details (for UP Personnel):
Name of bank (government depository bank):
Branch:
Account number:
Contact details:
Telephone number:
Mobile number:
E-mail address:
Signature of applicant:
I certify that the applicant/s is/are affiliated with the University of the Philippines.
______
Name and signature of
Chair/Director
Date:
I further certify that the journal in which the article appeared is indexed in the Web of Science (SCIE, AHCI, SSCI, and CPCI) or SCOPUS and that it is neither predatory nor hijacked.
______
Name and signature of
VCRD/VCRE or equivalent
Date:
OVPAA IPA Form 4.1 v.6-13-17.rjc/arm