Old Rural Bank Bldg.

, UP Los Baños, College, Laguna 4031

Tel. ( 049 ) 536 - 4009

DORMITORY ACCOMMODATION
INFORMATION FOR NEW FRESHMEN
SY 2018-2019

Isang maalab na pagpupugay sa mga bagong Iskolar ng Bayan para sa Bayan!

The UPLB Housing Office (UHO), through its Student Housing Division, welcomes you to UP Los Baños!

As you prepare your new journey as college students in our magnificent campus, may we ask you to prioritize your
dormitory accommodation.

The UHO manages ten student dormitories of UPLB which are located on campus. Four (4) of them can
accommodate New Freshmen (NF) students like you. A total of 568 female and 286 male NF students can be
accommodated in these dormitories. These are the Men’s Residence Hall and Forestry Residence Hall for FEMALE
NEW FRESHMEN students, and ATI Dorm and New Forestry Residence Hall for MALE NEW FRESHMEN students.

The processing of your application is on “First-Come, First-Served” basis, starting 21 May 2018. Complete
applications will be evaluated. Check-in will start on 23 July 2018.

Kindly, visit our website at www.uho.uplb.edu.ph to download the Application Form, Residence Hall Agreement and
Waiver.

PROCEDURE

1. Fill out the application form/ provide pertinent information legibly and accurately especially your email address and
phone number/s. Please attach supporting documents and submit your applications with complete attachments to your
chosen dormitory personally.

Telephone Number/Email
Dormitory Contact Person
Address
Men’s Residence Hall Mrs. Priscilla B. Ramirez 049 – 544 - 8344
Forestry Residence Hall Mrs. Cory M. Mariano 049 - 572 - 0500
ATI Dormitory Mr. Robin C. Botones 049 – 572 - 0496
New Forestry Residence Hall Mr. Crispin G. Gopela cris_gopela@yahoo.com

2. Limited slots are provided for applicants living in nearby towns, such as Los Baños, Sta. Rosa, San Pablo, Sta. Cruz in
Laguna and Tanauan, Batangas.

APPLICATION REQUIREMENTS

 Income Tax Return of parent/s/guardian or Certification of No Income from barangay of residency.

  Residence Hall Agreement (duly signed by parent/guardian, refer to the sample filled out form in the website)
 Waiver (duly signed by parent/guardian and notarized in the place of residence, refer to the sample filled out
 form in the website)
  2 copies of most recent passport size photo with name tag
  Clear copy of UP Admission Slip or Student Number (can be found on the release of UPCAT results)
 Initial payment:

If accommodated in Dormitory Fees You pay:

 Men’s Residence Hall
 Forestry Residence Hall
 New Forestry Res. Hall
 ATI Dorm
*Additional fees for the installation of appliances will be included in the succeeding bills.
Thank you.
 Reservation Fee – P 600 P 1,850
 Residence Fee (August) – P 600
 Reservation Deposit – P 600
 Key Deposit – P 50
 Reservation Fee – P 650 P 2,000
 Residence Fee (August) – P 650
 Reservation Deposit – P 650
 Key Deposit – P 50

ZOILO D. BELANO JR. (SGD)

Chief
 DORMITORY ACCOMMODATION
APPLICATION FORM
School Year 2018-2019

Please write legibly in blank ink. Provide complete information. Put NONE or NA if not applicable.

Basic Information
Applicant’s Name: _____________________________ __________________________________________ ________________________________
Last Name First Name Middle Name

Student No.: __________________________ Sex: Male Female

Course: __________________________ College: CA CAS CDC CEAT

CFNRCHE
 CPAFCVM CEM

Permanent Address: __________________ ___________________________ ____________________________ ________________________

House/Unit No. Apartment/Village Street/Road Barangay

________________________________________ ____________________________________________ _________________

Municipality/Town/City Province Zip Code

Distance from UPLB Gate (km): ______________________________

Contact Details: Provide information accurately.

Student’s Cellphone: Provider: _____________ No. ___________________ Student’s Email: __________________________

Provider: _____________ No. ___________________

Allergies and other
Health Concerns:

Parents or Guardian: Father : Landline: _____________ ___________________ Email: _________________________________

Area Code Phone Number

Cellphone: Provider: _________________ No. ____________________

Mother: Landline : _____________ ___________________ Email: ________________________________

Area Code Phone Number

Cellphone: Provider: _________________ No. ____________________

Income
Indicate if: Both parents have income Only one parent/guardian has income Dormitory Choice
Other source of income: None of the parents/guardian has income
For female NF:
Income 
Father’s Name: Php Supporting Document/s Submitted:
 Men’s Residence Hall
 Forestry Residence Hall
_________________ _____________________________________ (especially for CFNR students)
Mother’s Name: Php Supporting Document/s Submitted: For male NF:
_________________ _____________________________________  ATI Dormitory
 New Forestry Residence Hall
Legal guardian’s Name: Php Supporting Document/s Submitted:
_________________ _____________________________________

TOTAL GROSS FAMILY INCOME Php

_________________

DO NOT FILL UP. Evaluator only

Evaluator: ______________________________ Signature: ____________________________ Date:_____________________

 Complete Application Requirements?

RHA Passport size photo with name tag
Waiver UP Admission Slip

Accommodation:  YES Dorm/Unit/Room/Bed: _______________________________________________

NO REASONS:Incomplete/Incorrect Info Incomplete/Incorrect Documents Submitted

 Non-paymentNO MORE AVAILABLE BEDS