Application no.

Exam date

Paste your
2x2
picture here

School Year

Legal name Female

(Name in Birth Certificate) Last/Family First/Given Middle/Complete Male
Nickname
Present school

INSTRUCTIONS

1. Read the Admissions Brochure and all instructions carefully.

2. Fill out this form carefully and print or type all information requested. Write N/A if the information is not applicable to you. Omissions
can delay the processing of your application.
3. Please make sure to complete all the requirements in order to facilitate the processing of your application.
4. Submit this form together with the following documents: a) Secondary school record, b) Recommendation form, c) Personal essay
(printed on a short bond paper), d) NSO- authenticated Birth Certificate, e) three 2x2 identical pictures and f) Accomplished
Scholarship/ Financial aid form for those applying for grants.
5. The Application fee is non-refundable.

PERSONAL INFORMATION

Complete permanent address (Foreign students should specify their address at their country of origin)

Zip code
Mailing address (if not the same as above)

Zip code
Telephone number Fax number

E-mail address Mobile number

Birth date / / Place of birth

(mm) (dd) (yyyy)
Citizenship Filipino Others (pls. specify) Religion
Dual (pls. specify)
If married, name of spouse
(submit a copy of your marriage contract)

Does your family own a business? Yes No

If yes, specify name and nature of business

FAMILY INFORMATION

Father's name Mother's name

Last/Family First/Given Middle Last/Family First/Given Middle

Name of company/ employer Name of company/ employer

Present occupation/ position Present occupation/ position

Address Address

Business phone ( ) Mobile Business phone ( ) Mobile

Area Code Area Code

College (if any) College (if any)

Degree Year Degree Year

Graduate school (if any) Graduate school (if any)

Degree Year Degree Year

Sibling/s' educational attainment (eldest to youngest)

Name Age Highest educational attainment Last school attended
1
2
3
4
5

SCHOLASTIC INFORMATION

List all honors and awards you have received for academic excellence and co-curricular activities in high school.
Indicate when you received these.

List all the co-curricular organizations you have participated in. Indicate the position(s) held and year level(s)
when you were in office. (ex. Dramatics Club: Member I, II, Vice President-III; President- IV)

What special training program(s) or seminar(s) have you attended?

Have you failed any subject(s) in high school or college at the end of a term? Yes No
If yes, please indicate the failed subject(s), year level(s), and reasons.

Have you repeated a year in high school? Yes No Which year level? Why?

Have you ever been forced to stop schooling for at least a month because of health reasons? Yes No
If yes, please give details.

Please explain any gaps in school history, i.e. times you were not enrolled in any school. (if employed, please
submit a certification of employment)

Were you ever dismissed, suspended or placed under disciplinary probation? Yes No
If yes, please indicate offense(s) and sanction(s).

List all your sports, hobbies, interests, special skills and talents.

On a short bond paper, type an essay that conveys your interests (visual/ theater arts, sports, music, gourmet
cooking, etc.), accomplishments; family, educational, entrepreneurial, and social experiences; future goals,
including your strengths, weaknesses and your potentials which will positively contribute to the development of
the University (maximum of 250 words).
PROGRAM PREFERENCE

1. Please choose either the Five-year Combined Undergraduate and Graduate Programs or the Four-year
Undergraduate Bachelor's Programs.
2. Indicate your preferred course by specifying your first and second choice in the boxes provided in the chosen
program (Five-year or Four-year)
3. You can only choose one type of program, i.e., either the Five-year Combined Undergraduate and Graduate
Program, or the Four-year Undergraduate Bachelor's Program.

Five-Year Combined Undergraduate and Graduate Programs

Master of Arts in Humanities
Master of Arts in Political Economy
with Specialization in International Relations & Development
Master of Science in Industrial Economics
Master of Science in Management
Four-Year Undergraduate Programs
Bachelor of Science in Information Technology
Bachelor of Science in Entrepreneurial Management
Bachelor of Science in Applied Mathematics
Bachelor of Science in Business Administration
Major in Management
Bachelor of Arts Major in Humanities
Bachelor of Arts Major in Political Economy
Bachelor of Arts Major in Integrated Marketing Communications
Bachelor of Arts Major in Economics
Bachelor of Science in Human Capital Development
Major in Organizational Learning and Psychology *
Bachelor of Science in Child Development and Education*
Bachelor of Science in Industrial Engineering*
(5 years)

* Permit in process

Note:
Applicants to the Entrepreneurial Management Program have to take a diagnostic exam for an additional
fee of P250.00

CERTIFICATION

I hereby certify that I have read and fully understood all instructions regarding my application for admissions at
UA&P and that the information supplied in this application and the documentation supporting it are correct and
complete. I understand that incomplete or inaccurate information could be prejudicial to my admission. If accepted
as a student of the University of Asia and the Pacific, I agree to abide by all its policies and regulations.

APPLICANT'S SIGNATURE DATE