Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Look up keyword
Like this
0Activity
0 of .
Results for:
No results containing your search query
P. 1
Upcat Form 1 (Pds2014)

Upcat Form 1 (Pds2014)

Ratings: (0)|Views: 1|Likes:
Published by Tess De Lara Pangan
Upcat Form 1
Upcat Form 1

More info:

Published by: Tess De Lara Pangan on Jul 07, 2013
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PDF, TXT or read online from Scribd
See more
See less

07/07/2013

pdf

text

original

 
7.
HIGH SCHOOL
 
(where you completed/are completing secondary level education):
 Have you attended secondary level education anywhere else?
2 No 1 Yes (Where)
 Year of Graduation from Elementary LevelHigh School Name
(Do not abbreviate)
Month/Year 
 
of CompletionAddress
(City/Town,Province)
RegionHigh School Name & Address  Year 
THIS FORM IS FREE OF CHARGE AND MAY BE PHOTOCOPIED.
1.NAME OF STUDENT:
Print or type your full name in the following sequence: LAST NAME, FIRST NAME, MIDDLE NAME. Place one letter in each box. Leave one box blank between names.
2.SEX
1 Male 2 Female
3.DATE OF BIRTH
(Month, Day, Year)
- -4.PLACE OF BIRTH
(City/Town, Province)
5.MEMBER OF CULTURAL MINORITY GROUP?
2 No 1 Yes (Specify)
6.CITIZENSHIP
1 Filipino (If born abroad please submit a photocopy of a valid Philippine passport or a BOI Identification Certificate)2 Foreign (Specify) 3 Dual (Specify)
Staple hereStaple a recent 2" X 2" photograph(taken within the last six months) in thisbox.Be sure to print your name at the backof the photo.Staple here
LASTFIRSTMIDDLE
UPCAT Form 1
(Rev. 3-2013)
UNIVERSITY OF THE PHILIPPINES
UPCAT APPLICATION FOR FRESHMAN ADMISSION
FIRST SEMESTER AY 2014-2015
TO THE STUDENT AND PARENTS/GUARDIAN:
Carefully read the GENERAL INFORMATION BULLETIN ON FRESHMAN ADMISSION before filling out this application form.Print legibly all information required. Place X marks in appropriate boxes. Onlyaccomplished application forms,
UPCAT Form 1
and
UPCAT Form 2
(SecondarySchool Record) will be processed.
Testing Fee
:P450 US$50 US$100
Exempted
:TOP 10 INCOME
Deficiency/cies:
List of Top 10 across all curricular programs/annexesBIR Certificate / ITR / Cert of Compensation 2316Testing FeeF2 OTR GP/GR AffidavitPEPT GCSE/GCE Passport NBCR/ICR
Remarks:
{{
TO BE FILLED OUT ONLY BY PERSONNEL AUTHORIZED TO RECEIVEAND/OR PROCESS APPLICATIONS.Document Inventory Number 
 Received by Exemption Evaluator TP Checker 
VALID ONLY FOR UPCAT 2014
8.
UP CAMPUS APPLIED FOR
:
Choose from among the following (up to two choices allowed)1
UP Baguio, Baguio City
3
UP Extension Program Pampanga, Clarkfield, Pampanga
5
UP Visayas, Iloilo City
7
UP Manila, Manila
9
UP Mindanao, Davao City
2
UP Cebu, Cebu City
4
UP Diliman, Quezon City
6
UP Los Baños, Laguna
8
UP Tacloban College, Tacloban City
10
UP Open UniversityDo not indicate the same campus twice. Make sure that course choices are offered in the campus indicated. Write NONE on the blank if you do not have other choices of campus/course.Countersign all erasures and corrections made. Do not indicate INTARMED or Medicine in any of the blanks for Intended Course. Please refer to question No. 9 below.
UP CAMPUS
INTENDED COURSE
(See list of Undergraduate Degree Programs)
COURSE CODE
1st choice1st choice2nd choice2nd choice1st choice2nd choice9.Are you also interested in entering an accelerated program leading to Medicine?
2 No 1 Yes (Only those indicating their interest will be considered for this program)
10.
UPCAT TEST CENTERS
(by Region). Mark the UPCAT Test Center nearest your school. (Mark only one.)
NOTE: Whenever possible, applicants will be issued Test Permits for a testing center in their respective provinces.REGION 1 (ILOCOS)
0103Batac, Ilocos Norte0122Dagupan City0126San Fernando City, La Union0125Urdaneta City0129Vigan City
REGION 2 (CAGAYAN VALLEY)
0202Aparri,Cagayan0201Basco, Batanes0206Bayombong, Nueva Vizcaya0207Diffun, Quirino0208Ilagan, Isabela0223Tuguegarao City
REGION 3 (CENTRAL LUZON)
0399Angeles City0327Balanga City0307Baler, Aurora0322Cabanatuan City0332Malolos City0302Meycauayan, Bulacan0323Olongapo City0326Tarlac City0321UPEPP, Clarkfield, Pampanga
REGION 4-A (CALABARZON)
0429Antipolo City0499Bacoor, Cavite0421Batangas City0403Imus, Cavite0424Lucena City0428Trece Martires City0404UP Los Bos, Laguna
REGION 4-B (MIMAROPA)
1701Boac, Marinduque1721Calapan City1704Cuyo, Palawan1705Odiongan, Romblon1722Puerto Princesa City1702San Jose, Occidental Mindoro
REGION 5 (BICOL)
0502Daet, Camarines Norte0522Legazpi City0525Masbate City0523Naga City0526Sorsogon City0504Virac, Catanduanes
REGION 6 (WESTERN VISAYAS)
0621Bacolod City0601Kalibo, Aklan0626Roxas City0602San Jose, Antique
REGION 11 (DAVAO)
1121UP Mindanao, Davao City1124Digos City1123Tagum City
REGION 12 (SOCCSKSARGEN)
1228Cotabato City1225Gen. Santos City1204Kabacan, North Cotabato1226Koronadal City1227Tacurong City
REGION 13 (CARAGA)
1321Butuan City1302Prosperidad, Agusan del Sur 1322Surigao City1304Tandag, Surigao del Su
REGION 14 (CAR)
1403Banaue, Ifugao1401Bangued, Abra1405Bontoc, Mt. Province1407Tabuk, Kalinga1421UP Baguio, Baguio City
NATIONAL CAPITAL REGION
1624UP Diliman, Quezon City1622UP Manila, Manila0624UP Visayas, Iloilo City
REGION 7 (CENTRAL VISAYAS)
0725Dumaguete City0704Larena, Siquijo0728Tagbilaran City0723UP Cebu, Cebu City
REGION 8 (EASTERN VISAYAS)
0804Borongan, Eastern Sama0805Catarman, Northern Sama0806Catbalogan, Western Sama0824Maasin City0801Naval, Biliran0822Ormoc City0823UP Tacloban College, Tacloban City
REGION 9 (ZAMBOANGA PENINSULA)
0922Dipolog City0923Pagadian City0924Zamboanga City
REGION 10 (NORTHERN MINDANAO)
1022Cagayan de Oro City1030Iligan City1028Malaybalay City1004Mambajao, Camiguin1024Oroquieta City

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->