College of Mass Communication  University of the Philippines

Diliman
Application for Admission to a Graduate Program
Guidelines for printing this page
1. This application form uses Arial as its default font. General font size is 10, except for the major headings.
2. Default margins are 0.8 inches in all sides.

Instructions to applicants
1. Please type or print all entries.
2. Submit this form completely with the following to the above address:
 Formal letter of application addressed to the Dean, College of Mass Communication 1x1
 P200 or $50 application fee, payable to the Cashier, PNB Bldg., UP Campus Branch updated
(behind UP Shopping Center) picture
 Xerox copy of the official transcripts of undergraduate and/or graduate records
(original to be presented for verification)
 Certified copy of diploma or certificate of graduation

Personal Details
Name: (Mr/Miss/Mrs)
Home Address:
Mobile Phone: Tel. No.
Business/Office Address:
Email Address: Tel. No.
Age Gender
Date of Birth Place of Birth
Citizenship Nationality
Graduate Degree Program
Major
Applied for
Proposed Start of
[ ] First Semester [ ] Second Semester AY
Graduate Study
Source of Financial Support
Are you applying under a special arrangement or
scholarship program? If YES, indicate collaborating
university or funding agency
Have you ever applied to any graduate program at any
other time? (If YES, indicate university, field of study,
semester and year)

 Room 105, Annex Building, Plaridel Hall, Ylanan Street, UP Diliman, 1101 Quezon City, Philippines
 (63-2) 981-8500 loc 2671  http://masscomm.upd.edu.ph
 College of Mass Communication  University of the Philippines
Diliman
For the following items, please use a separate sheet if necessary.

Academic Background
Name & Address of School Inclusive Dates Degreee Honors
(month & year) Completed Obtained

Academic Honors, Awards, Scholarships

Membership in Learned Societies or Professional Organizations (indicate positions held, if any)

Work experience (list in chronological order)

Inclusive Dates
Name & Address of Employer Position Held Nature of Job
(month & year)

Papers published or presented at meetings, seminars and/or conferences

STATEMENT OF PURPOSE AND RESEARCH PLAN

Write a clear and concise essay of not more than 300 words on your purpose in applying to this graduate
program and your plans for graduate study and your research plan for the Thesis/Dissertation, if admitted.
Include your specific area/areas of interest, an assessment of your academic, mental and emotional
preparedness for graduate study, and your future prospects. Use a separate sheet if necessary.

 Room 105, Annex Building, Plaridel Hall, Ylanan Street, UP Diliman, 1101 Quezon City, Philippines
 (63-2) 981-8500 loc 2671  http://masscomm.upd.edu.ph