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TEST DATE: 2010-12-12

NMAT IDENTIFICATION FORM


(Must be presented to the Examiner on the day of the test)

BANK REFERENCE NUMBER: NMAT APPLICATION NUMBER:


3561897387 1121001912

NAME: PANTILLO, APRIL LINE ALFECHE

COLLEGE GRADUATING/GRADUATED FROM: YEAR GRADUATING/GRADUATED:

[St. Michael's College] Iligan City, Lanao Del Norte 2011

FOR THE EXAMINER: FOR THE APPLICANT:


Please verify that the person presenting this Please bring this Form to the nearest Bank of the
Form is the same as the one in the picture. Philippine Islands (BPI) branch and pay the
NMAT Registration and Test Fees (PhP1900.00
PHP) on or before November 17, 2010. Copy
FOR THE SCHOOL HEAD: Attach a 2" x 2" exactly the Bank Reference Number found on
Please affix your signature on the lower front colored photo here, top of this Form and CEM's BPI account
portion extending beyond the edges of the then have it signed by number 1881-0450-24 on the BPI Payment /
applicant's picture, attesting to the fact that the your School Head. Deposit Slip. Verify your NMAT application
person getting your signature is the same person status after two banking days to download the
who will take the NMAT. NMAT Practice Set and the Supplementary
Handout.

I hereby certify that the person in the above picture is one and the same as the NMAT applicant who is graduating/has graduated from this institution on the date
specified above and whose signature appears below.

Printed Name of School Head

Designation of School Head Signature of Applicant

1121001912 Page 1 of 1 FORM NMAT-ONLINE-BOI-0001

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