Republic of the Philippines Department of the Interior and Local Government Philippine Public Safety College PHILIPPINE NATIONAL

POLICE ACADEMY P.O. Box # 37 Camp General Mariano N Castaeda, Silang, Cavite 4129 Tele Fax # (049) 545-5940/(02) 396-4076 Website: www.pnpa.edu.ph Email Add: info@pnpa.edu.ph
PNPACAT Application Form Revised 2010
PNPA REG

Recent Photo With name tag Original Copy (Passport Size) [1.5x2]

APPLICATION FOR PNPA CADET ADMISSION TEST

(IMPORTANT: READ INSTRUCTIONS AT THE BACK OF THIS FORM. ACCOMPLISH THIS FORM COMPLETELY & ACCURATELY)

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 Female

Email Address:______________________ TEL NO.: (Res)_____________________ (Mobile)___________________________ 6. HEIGHT: (cm) 7. WEIGHT: (kg)

Month Date

Year

9. BIRTHPLACE:_______________________________________________ (City/Town/Province)

10. FATHERS NAME: _____________________________ ADDRESS ______________________________________________ 11. MOTHERS NAME: _____________________________ ADDRESS______________________________________________ 12. GUARDIANS NAME: ___________________________ Relationship ________________ ADDRESS___________________ 13. EDUCATION (Please check highest educational attainment only)

High School Graduate: College Undergraduate: College Graduate: Degree: _________________________________________ School: _______________________ Year 1st 2nd 3rd 4th 5th ______________________________ Level: [ ] [ ] [ ] [ ] [ ] School: ________________________ Year Graduated: ________________ Course: ____________________________ _______________________________ School: Year Graduated: _________________
14. Have you ever been dismissed from any employment, forced to resign or otherwise disciplined as a result of administrative case, or convicted of any violation of law, ordinance or regulations before any civil court and/or military tribunal? : YES NO If YES, attach copy of decision: 15. Do you have any pending criminal or administrative case, or civil case on file before any Prosecutors Office or Court of Justice or other derogatory record(s)? YES NO 16. Do you have any parental obligation, or has 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) TEST CENTER PREFERENCE: (Please CHECK your test center preference) REGION I II III IV A & B V VI AREAS Laoag City San Fernando City, La Union Tuguegarao City Cauayan, Isabela Cabanatuan City City of San Fernando, Pampanga Calamba City Lucena City Legazpi City Daet, Camarines Norte Iloilo City Bacolod City CODE 001 002 003 004 005 006 007 008 009 010 011 012 REGION VII VIII IX X XI XII NCR CAR CARAGA ARMM AREAS Cebu City Tacloban City Zamboanga City Cagayan de Oro City Davao City General Santos City Quezon City Manila Baguio City Lamut, Ifugao Butuan City Cotabato City CODE 013 014 015 016 017 018 019 020 021 022 023 024

(REPRODUCTION OF THIS FORM IS ALLOWED) Application Form can be downloaded at www.pnpa.edu.ph

INSTRUCTIONS
Please read instructions carefully. Be sure to meet the qualification requirements. Inaccurate or incomplete information will be a ground for disqualification. SUBMIT ONLY ONE (1) APPLICATION. 1. Verify if you posses the following INITIAL REQUIREMENTS FOR ADMISSION: (DO NOT APPLY if you are NOT QUALIFIED) A natural born Filipino citizen; Of good moral character; Male or female, single and with no legal obligation to support a child or children; 17 to 21 years old (Born between May 2, 1989 May 1, 1994); Height of 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 weight measurement 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 5:30

Male 10 40 55 17 sec 4:30

Physically and mentally fit for cadetship training; No criminal, administrative, or civil case on file before any Prosecutors Office or any Court of Justice and other derogatory record(s); Not a former cadet of PNPA or other service academies.
Defective Visual Perception (color blindness, near sighted/far sighted with corrective eyeglasses or lens); Physical Deformities Example: bowlegged or congenital 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 liver diseases, epileptic seizure disorders, major operations; communicable diseases (such as AIDS, Hepatitis, VD etc.) Full dentures, upper and lower, Cleft lip and palate, Malocclusion, Deformities of the face, Open bite, Tongue-tied; Missing of four anterior or front teeth & Missing of six (6) posterior/molar teeth; Tattoos and other brotherhood marks, ear piercing (male only) For Females: 1. Goiter 2. History of pregnancy 3. Presence of breast mass 4. Painful menstruation Communication Skills Math and Sciences Logical and Reasoning Ability General Information and Current Events Values and Aptitude for the Service

2. GROUNDS FOR MEDICAL DISQUALIFICATION:

3. COVERAGE OF EXAMINATION:

4. Submit duly accomplished application together with a self-stamped WINDOW ENVELOPE to the Office of the Registrar or mail to: The Director, (Attn: Registrar), Philippine National Police Academy, Camp General Mariano N Castaeda, 4129 Silang, Cavite. 5. DEADLINE FOR SUBMISSION OF APPLICATION: September 30, 2010 6. NOTICE OF EXAMINATION shall be sent through mail. Applicants who failed to receive the notice of examination must visit the PNPA website: www.pnpa.edu.ph to check if he/she included in the List of Qualified Examinees. If found qualifed, applicants shall go directly to examination area even without notice of examination and bring the other test requirements. APPLY NOW : The PNPA Cadet Admission Test will be on November 07, 2010.
MOTTO: TO LEARN TODAY, TO LEAD TOMORROW