Republic of the Philippines Department of the Interior and Local GovernmentPhilippine Public Safety College PHILIPPINE NATIONAL POLICE ACADEMY P.O. Box # 37Camp General Mariano N Castañeda, Silang, Cavite 4129 Tele Fax # (049) 545-5940/(02) 396-4076 Website: www.pnpa.edu.ph Email Add: info@pnpa.edu.phPNPACAT Application Form Revised 2009Recent Photo With name tag Original Copy (Passport Size) [1.5’x2”]APPLICATION FOR PNPA CADET ADMISSION TEST(IMPORTANT: READ INSTRUCTIONS AT THE BACK OF THIS FORM. ACCOMPLISH THIS FORMCOMPLETELY & ACCURATELY) TEST CENTERPREFERENCE:__________________________________________________________________________ CODE: ___________1. SURNAME FIRST NAME MIDDLE NAME 3. COMPLETE MAILING ADDRESS with ZIP Code: 4.CIVIL STATUS: 8. AGE : BIRTHDATE: 5. CITIZENSHIP: REGION:______2.GENDER : Male FemaleEmail Address:______________________ TEL NO.: (Res)_____________________(Mobile)___________________________ 6. HEIGHT: (cm) 7. WEIGHT: (kg)Month DateYear9. BIRTHPLACE:_______________________________________________ (City/Town/Province)10. FATHER’S NAME: _____________________________ ADDRESS______________________________________________ 11. MOTHER’S NAME:_____________________________ADDRESS______________________________________________ 12. GUARDIAN’S NAME:___________________________ Relationship ________________ADDRESS___________________ 13. EDUCATION (Please check highest educationalachievement only)High School Graduate: College Undergraduate: College Graduate: Degree:_________________________________________ School: _______________________ Year 1st2nd 3rd 4th 5th ______________________________ Level: [ ] [ ] [ ] [ ] [ ] School:________________________ Year Graduated: ________________ Course:____________________________ _______________________________ School: YearGraduated: _________________14. Have you ever been dismissed from any employment, forced to resign orotherwise disciplined as a result of administrative case, or convicted of anyviolation of law, ordinance or regulations before any civil court and/or militarytribunal? : YES NO If YES, attach copy of decision: 15. Do you have any pendingcriminal or administrative case, or civil case on file before any Prosecutor’sOffice or Court of Justice or other derogatory record(s)? YES NO 16. Do you haveany parental obligation, or has sired a child or children? YES NO I hereby declareunder the penalties of perjury that this application has been accomplished in goodfaith, verified by me and to the best of my knowledge and belief and is a true,correct and complete statement pursuant to the provisions of pertinent laws, rulesand regulations of the Republic of the Philippines._______________________________ (Signature of Applicant) Region AREAS CODE RegionAREAS CODE1 2 3 4A&B 5 6

Laoag City 001 San Fernando City, La Union 002 Tuguegarao City 003 Cauyan, Isabela004 Cabanatuan City 005 San Fernando City, Pampanga 006 Calamba City 007 LucenaCity 008 Daet, Camarines Norte 009 Legazpi City 010 Iloilo City 011 Bacolod City012Cebu City Tacloban City Zamboanga City Cagayan de Oro City Davao City GeneralSantos City Taguig City Quezon City City of Manila CAR Baguio City Lamut, IfugaoCARAGA Butuan City ARMM Cotabato City7 8 9 10 11 12 NCR013 014 015 016 017 018 019 020 021 022 023 024 025(REPRODUCTION OF THIS FORM IS ALLOWED) Application Form can be downloaded atwww.pnpa.edu.ph

INSTRUCTIONSPlease read instructions carefully. Strictly comply with the qualificationrequirements. Inaccurate or incomplete information shall be a ground fordisqualification. PLEASE SUBMIT ONLY ONE (1) APPLICATION. 1. Check if you have thefollowing INITIAL REQUIREMENTS FOR ADMISSION. (PLEASE DO NOT APPLY if you are NOTQUALIFIED) • • • • • • • • A natural born Filipino citizen; Of good moralcharacter; Male or female, single and with no legal obligation to support a childor children; 17 to 21 years old (Born between May 2, 1988 – May 1, 1993); Heightof at least 162.5 cm (5ft 4 in) for male, and 157.5 cm (5ft 2 in) for female;Weight of not more nor less than five (5) kilograms of the standard weightmeasurement corresponding to height, age and sex; At least high school graduate;Must be able to perform the following physical fitness exercises: Exercises Pull-Ups Full Arms Hanging 2 min Push-Ups 2 min Sit-Ups 100 meter dash 1000 meter run •••Female 40 sec 35 50 20 sec 5:30Male 10 40 55 17 sec 4:30Physically and mentally fit for cadetship training; No criminal, administrative,or civil case on file before any Prosecutor’s Office or any Court of Justice andother derogatory record(s); Not a former cadet of PNPA or other service academies.Defective Visual Perception (color blindness, near sighted/far sighted withcorrective eyeglasses or lens); Physical Deformities Example: bowlegged orcongenital defects; Perforated ear drum, chronic sinusitis, bleeding tendencies,hemorrhoids, hernia (if not treated), varicocoele; extensive skin disorders;History of heart disease, hypertension, asthma, active PTB, kidney and liverdiseases, epileptic seizure disorders, major operations; communicable diseases(such as AIDS, Hepatitis, VD etc.) Full dentures, upper and lower, Cleft lip andpalate, Malocclusion, Deformities of the face, Open bite, Tongue-tied; Missing offour anterior or front teeth & Missing of six (6) posterior/molar teeth; Tattoosand other brotherhood marks, ear piercing (male only) Add’l for Females: 1. Goiter2. History of pregnancy 3. Presence of breast mass 4. Painful menstruationCommunication Skills Math and Sciences Logical and Reasoning Ability GeneralInformation and Current Events Values and Aptitude for the Service2. GROUNDS FOR MEDICAL DISQUALIFICATION:• • •• • • •3. COVERAGE OF EXAMINATION:• • • • •4. Submit duly accomplished application together with a self-stamped WINDOWENVELOPE to the Office of the Registrar or mail to: The Director, (Attn:Registrar), Philippine National Police Academy, Camp General Mariano N Castañeda,4129 Silang, Cavite. 5. DEADLINE FOR SUBMISSION OF APPLICATION: September 30, 20096. NOTICE OF EXAMINATION shall be sent through mail or you may visit our website:www.pnpa.edu.ph for the list of qualified examinees, place of examination, andother test requirements. APPLY NOW : The PNPA Cadet Admission Test will be onOctober 25, 2009 (Sunday), 7:00amMOTTO: TO LEARN TODAY, TO LEAD TOMORROW