Recent 2x2 I.D.

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APPLICATION FOR COLLEGE ADMISSION
School Year: 201__ - 201__ Semester: 1st 2nd

Application Number:

Name: _____________________________________________________________________________________________________________________________
Last Name First Name Middle Name

Freshman Transferee Degree Holder

INSTRUCTION:
1. Read the accompanying brochure, procedures and all instructions very carefully.
2. Fill out this form legibly in print or type all information requested. Write N/A if the information is not applicable to you.
INCOMPLETE APPLICATION FORMS WILL NOT BE PROCESSED.
3. The application and testing fee is non-refundable and non-transferrable.
4. Submit this form at the examination site on the date of your test as shown in the UACET Examination Permit with the
following:
a. Accomplished Recommendation Form from the Principal or Guidance Counselor. The form is downloadable
from www.ua.edu.ph
b. UACET Examination Permit
c. Certificate of Good Moral Character
d. Photocopy of Grade 12 report card with grades in the most recent grading period or Grade 11 card
e. 2 copies of 2 x 2 close up picture with white background
5. Those applying for scholarship must ask for a SCHOLARSHIP APPLICATION FORM or download the same from
www.ua.edu.ph/scholarships. Fill out the form and submit it together with the requirements specified in item 4 above.

PERSONAL INFORMATION:
Permanent Address: ____________________________________________________________________________________________________
No. Street Barangay/Village Town/City Province

Telephone Number _____________________ Mobile Number ____________________________ E-mail add.: ___________________________

Birth Date: ___________________ Birth Place: __________________________________________________________________ Age:___________

mm/dd/yyyy Municipality/City Province

Religion: _________________________ Citizenship: ___________________ Civil Status: _______________ Gender:______________

IF WORKING: Name of Company: ___________________________________________________ Nature of work: ________________________

FAMILY INFORMATION:
FATHER Living Deceased MOTHER Living Deceased Guardian/Spouse(if applicable)
Name
Telephone Number
Mobile Number
Email Address
Occupation
Company Address
Less than P7,890 P31,561 – P78,900 P118,351 – P157,800
Monthly Family
Income
P7,891 – P15,780 P78,901 – P118,350 P157,800 and above
P15,781 – P31,560

ACADEMIC INFORMATION 

Senior High School Strand: ____________________ Name of School: ____________________________________________________________

Name of Principal: ______________________________________ Name of Guidance Counselor: ____________________________________

Are you a candidate for:  With Highest Honors With High Honors With Honors
DEGREE BEING APPLIED FOR

(Rank three (3) programs that you wish to take, with 1 as top priority, 2 as second priority and 3 for least priority)

BS in Accountancy BA in Communication BS in Industrial Engineering

BS in Architecture BS in Electronics Engineering BS in Information Technology
BS in Business Administration
Bachelor in Elementary Education BS in Nursing
major in Marketing Management
BS in Business Administration
Bachelor in Secondary Education BS in Psychology
major in Operations Management
BS in Hotel and Restaurant
BS in Civil Engineering BS in Tourism Management
Management
BS in Computer Engineering

My course is: my choice my parent’s choice Others, please specify: __________________________________________

Reason for choosing the course: _________________________________________________________________________________________________

Reason for applying in UA: _______________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________

SCHOLARSHIP

Are you applying for SCHOLARSHIP or GRANT: YES  NO

If yes, please secure a copy of the SCHOLARSHIP APPLICATION FORM from the Guidance and Admissions Office or download
the same from www.ua.edu.ph/scholarships.

I hereby certify that the above-written information is true and correct. I agree to comply with all the admission
requirements and procedure of the University of the Assumption. Otherwise, my admission/enrolment will be invalidated.

____________________________________________________ __________________________________
Parent/ Guardian Signature Over Printed Name Relationship
______________________________________ ____________________________________
Applicant’s Signature Date of Application

ENTRANCE TEST RESULTS

Verbal
Test Given Raw Score Percentile Rank Stanine
Interpretation

Recommendations: __________________________________________________________________________________________________

____________________________
Counselor’s Signature