NMAT

National Medical Admission Test

IDENTIFICATION (ID) FORM
(Must be SUBMITTED to the Examiner on the day of the test)

Application No.: 1101710169

MAHAR, VASUDHA
Card Transaction No.: 2000012626
Name of Applicant (name that will appear on your Answer Sheets and Examinee Report Form)
1997-05-17 Female India Single
Birthdate Sex Nationality Civil Status
Angeles University Foundation, Angeles City, Pampanga
Name of College Graduating From
Pampanga Philippines
2 X 2 ID Picture
State/Province of College Graduating From Country of College Graduating From
BS in Psychology 2017-2018
College Course (Bachelors Degree) School Year Graduating

contact information
ROOM NO.A 2 FLOOR AUF COOP M.PONCE STREET, CLARO M. RECTO, ANGELES CITY, PAMPANGA 2009 Philippines
Home Address
Test Center: Manila
ROOM NO.A 2 FLOOR AUF COOP M.PONCE STREET, CLARO M. RECTO, ANGELES CITY, PAMPANGA 2009 Philippines
Test Date: October 22, 2017
Mailing Address
Results to be: Sent via postal mail
N/A +63-9422608185 1996hannah.vasudhamahar@gmail.com
Test results and NMAT ID information released
to requesting medical schools? No Landline Mobile E-mail
(For Foreign Applicant only)
Medical School Choices:
1. Angeles University Foundation - College of Medicine P4528808 October 17, 2026 DEHRADUN
2. Emilio Aguinaldo College - College of Medicine Passport No. Expiry Date Place of Issue

3. Our Lady of Fatima University - College of Medicine

FOR THE NMAT APPLICANT

1. Bring this Form to your school. Your School Head must affix his/her signature on the space provided below to certify that you can graduate by the end of the
school year stated above.
2. Visit the NMAT website to verify the status of your NMAT application and to download the NMAT Practice Set.
3. Visit the NMAT website two weeks before the test date to know your room assignment and to download your Examination Permit.
4. Affix your signature on the certification below:

I hereby certify that I have read, fully understood, and accepted all the information, terms and conditions specified on the NMAT Bulletin of Information and on
the NMAT website www.cem-inc.org.ph/nmat, including, among others, the NMAT policies on refund of test fees, on cheating or improper test-taking behavior in
any manner or form, and on failure to take or complete the test on the test date and test center indicated on this Form. I further certify that all information I gave
on this Form is true and correct to the best of my knowledge and that any misinformation shall constitute grounds for my disqualification from taking the NMAT
or invalidation of my NMAT results.

Applicants Signature Date Signed

FOR THE SCHOOL HEAD

Please affix your signature on the space provided below to confirm the identity and academic status of the NMAT applicant.

I hereby certify that the person in the picture above can graduate from ________________________________________________________________
Angeles University Foundation, Angeles City, Pampanga

with a college (bachelors) degree of/in ____________________________________________________________

BS in Psychology by the end of school year ______________.
2017-2018
He/She can apply for admission to any Philippine medical college in the next schoolyear ________________.
2018-2019

Signature & Printed Name of School Head Designation Date Signed

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