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PHILIPPINE NATIONAL POLICE ACADEMY
Camp General Mariano N Castaneda, Silang, Cavite 4129 Tele Fax # (049) 545-5939/ (0939) 9393769 Website: www.pnpa.edu.ph Email Add: email@example.com
APPLICATION FOR CADET ADMISSION TEST
(IMPORTANT: READ THE INSTRUCTIONS AT THE BACK OF THIS PAGE BEFORE ACCOMPLISHING THIS APPLICATION FORM.)
SURNAME FIRST NAME MIDDLE NAME
RECENT PHOTO IN PASSPORT SIZE WITH NAME TAG AND WHITE BACKGROUND (DIGITAL
PHOTO IS NOT ACCEPTED)
SEX . MALE
AGE FEMALE E
CIVIL STATUS SINGLE SINGLE PARENT MARRIED WIDOWED
HEIGHT 5 BELOW 5’2
COMPLETE MAILING ADDRESS with ZIP Code: BIRTHDATE(date/month/year) BIRTHPLACE (city/town/province) CITIZENSHIP
FAMILY BACKGROUND FATHER’S NAME:____________________________ CONTACT NUMBER:_______________ ADDRESS: _________________________________________________________________ MOBILE PHONE NUMBER: MOTHER’S NAME:___________________________ CONTACT NUMBER: ______________ ____________________ ADDRESS: _________________________________________________________________ ____________________ GUARDIAN’S NAME: _________________________ RELATIONSHIP:___________________ ADDRESS: _________________________________ CONTACT NUMBER:_______________ EDUCATIONAL ATTAINMENT COLLEGE/VOCATIONAL HIGH SCHOOL LEVEL: 1ST 2ND 3RD 4TH 5TH Year Graduated:____________ SCHOOL________________________________ SCHOOL:___________________________________________________ GENERAL AVERAGE (RATING):_______________ COURSE: ___________________________________________________ ACADEMIC AWARDS: _____________________ ACADEMIC AWARDS: _________________________________________ OTHER AWARDS:_________________________ OTHER AWARDS: ____________________________________________ CIVIC ORGANIZATIONS/AFFILIATION:_________________________ POSITION HELD: _______________________________ SPORTS : _________________________________ HIGHEST SPORTS ACHIEVEMENT: _________________________________ OTHER SKILLS:___________________________________________________________________________________________ Have you ever been dismissed from any employment, forced to resign or otherwise disciplined as a result of an administrative NO case, or convicted for any violation of law, ordinance or regulations before any civil court and/or military tribunal? YES If YES, please attach copy of the decision. Do you have any pending criminal or administrative case or civil case on file before any Prosecutor’s Office or Court of Justice or other derogatory record(s)? YES NO Do you have any parental and/or financial obligation, or have sired a child or children? YES NO I hereby declare under the penalties of perjury that this application has been accomplished in good faith, 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, rules and regulations of the Republic of the Philippines. __________________________ (Signature of Applicant)
5’2 5’3 5’4 5’5 5’6 5’7 5’8 5’9 5’10 5’11 6’0 ___ OTHERS
EMAIL ADDRESS: ___________________ ___________________ TEL/LANDLINE NUMBER: ___________________ ___________________
NOTICE OF EXAMINATION OR ADMISSION NOTICE from the PNPA REGISTRAR shall be sent through mail. Applicants who fail to receive notice of examination may visit the PNPA website at www.pnpa,edu.ph to check if he/she is included in the List of Qualified Examinees. If found qualified, applicants may go directly at the designated examination areas on the date of examination even without the notice of examination. Applicants shall present valid personal identification cards (ID’s) together with other requirements. “ TO
LEARN TODAY, TO LEAD TOMORROW”
(REPRODUCTION OF THIS FORM IS ALLOWED) Application form can be downloaded at www.pnpa.edu.ph
active PTB. • Weight must not be more than or not less than five (5) kilograms of the standard weight corresponding to height. and sex. • History of heart disease. Cadets shall reimburse the government expenses for his/her scholarship should he/she fail to complete the Cadetship Program. PUT A CHECK ON THE BOX BESIDE THE TEST CENTER CODE. Inaccurate or incomplete information will be ground for disqualification. 2. • Preferably 5feet 4inches in height for male. Submit duly accomplished application together with a self-stamped WINDOW ENVELOPE to the Office of the Registrar or mail to: The Director. Painful menstruation. • Male or female. upper and lower. epileptic seizure disorders. hernia (if not treated). Isabela Cabanatuan City City of San Fernando. malocclusion. hemorrhoids. 3. kidney and liver diseases. • Must be able to pass the minimum required physical fitness exercises: Exercises Male Female Pull-Ups 3 Full Arms Hanging 30seconds Push-Ups(2 minutes) 15 10 Sit-Ups (2 minutes) 30 25 100 meter dash 18seconds 20seconds 3 km run 27minutes 30minutes • Physically and mentally fit for cadetship training. Tawi-Tawi CODE 013 014 030 015 027 016 017 018 019 020 021 022 023 024 028 V VI Legazpi City Naga City Iloilo City Bacolod City Kalibo. asthma. BFP or BJMP services for the prescribed period (two years of service for every year of scholarship). DEADLINE FOR SUBMISSION OF APPLICATION: September 24. Cavite.INSTRUCTIONS Please read instructions carefully. sexually transmitted infection such as AIDS. VD etc. ear piercing (male only). 2012 PNPA Cadet Admission Test will be on October 28. • 17 to 21 years old at the time of admission. major operations. administrative. Hepatitis. • At least high school graduate. Deformities of the face. Philippine National Police Academy. single and with no parental obligation. • Any other similar defects which may hinder in the Cadetship Training Program. COVERAGE OF EXAMINATION • Communication Skills • General Information and Current Events • Logical and Reasoning Ability • Values and Aptitude for the Service • Math and Sciences 5. REQUIREMENTS FOR ADMISSION: (DO NOT APPLY if you are NOT QUALIFIED) • Natural born Filipino citizen. chronic sinusitis. History of pregnancy. REGION I II III IV A & B LOCATION Vigan City Dagupan City Tuguegarao City Cauayan. bleeding tendencies. near sighted/far sighted with corrective eyeglasses or lens. Ifugao Butuan City Cotabato City Bongao. age. Aklan . Romblon Dasmariñas City TEST CENTER PREFERENCE CODE REGION 001 002 003 004 005 006 007 008 025 029 009 010 011 012 026 CARAGA ARMM CAR X XI XII NCR IX VII VIII LOCATION Cebu City Tacloban City Catarman. 4. • Of good moral character. PLEASE CHOOSE YOUR TEST CENTER PREFERENCE INDICATED BELOW. • Tattoos and other brotherhood marks. The PNPA Cadetship Program is a government Scholarship Program. Pampanga Calamba City Lucena City Odiongan. 2012 7. GROUNDS FOR MEDICAL DISQUALIFICATIONS: • Defective Visual Perception (color blindness. 6. • Must not be a former cadet of PNPA or other service academies. varicocoele. (Attn: Registrar). • Full dentures. and 5feet 2inches for female except for indigenous people. missing of four(4) anterior or front teeth & Missing of six (6) posterior/molar teeth. or civil case and other derogatory record(s). Northern Samar Zamboanga City Pagadian City Cagayan de Oro City Davao City General Santos City Quezon City Manila Baguio City Lamut. Tongue-tied. Be sure to meet the qualification requirements. • For Females: Goiter. Admitted Cadets must complete the Cadetship Program and serve the government either in the PNP. SUBMIT ONLY ONE (1) APPLICATION. extensive skin disorders. Cleft lip and palate. 1. Camp General Mariano N Castañeda. Open bite. hypertension. • Have no criminal. • No financial obligations. 4129 Silang. • Physical Deformities (bowlegged or congenital defects) • Perforated ear drum. nystagmus). Presence of breast mass.
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