CONTROL NUMBER

Please attach recent

colored photo ID here
TALENT DETERMINATION TEST (TDT)
2“ x 2”
APPLICATION FORM
This will serve as your TDT ID number
Instructions:
1. Please type entries or write legibly 2. Proper noun should be written in full and not in abbreviated form 3. Please mark [x] boxes properly

Current College: ____________________________ Degree/ Program: ______________________

Earned 30 Academic Units w/ at least a minimum GWA of 2.75, GWA of ____
Certified True Copy of Grades 3 pcs. 2” x 2 “colored ID pictures
NOTE: ORIGINAL AND PHOTOCOPY OF DOCUMENTS MUST BE PRESENTED UPON APPLICATION.

PERSONAL INFORMATION COURSE APPLYING FOR

NAME ___________________________________________________________________________
Last First Middle/Maiden Bachelor of Fine Arts
ADDRESS ___________________________________________________________________________
IF ACCEPTED, WHERE DO YOU PLAN TO LIVE? _____________________________________________ Certificate Program
BIRTHDAY ______/_______/___________ BIRTHPLACE ________________________

SEX MALE FEMALE

DEGREE APPLYING FOR

CIVIL STATUS SINGLE WIDOWER MARRIED SEPARATED

Art Education
CITIZENSHIP _______________________ RELIGION __________________________

MOBILE PHONE NUMBER _______________________________________ Art History

EMAIL ADDRESS _______________________________________________ Industrial Design

DO YOU HAVE A DISABILITY? YES NO
Painting
IF YES, PLEASE SPECIFY AND ATTACH MEDICAL CLEARANCE: ________________

DO YOU HAVE MEDICAL CONDITION? YES NO

Sculpture
IF YES, PLEASE SPECIFY AND ATTACH MEDICAL CLEARANCE: ________________
Visual Communication
ARE YOU A WORKING STUDENT? YES NO IF YES, WHAT WORK? ________________________

SCHEDULE _______________________________________ MONTHLY INCOME ₱_______________________

DO YOU HAVE ANY OTHER TALENTS? ____________________________________________________
ARE YOU A MEMBER IN ANY ART GROUP/INSTITUTION? YES NO TO BE ACCOMPLISHED BY THE
IF YES, PLEASE SPECIFY ___________________________________ FACULTY INTERVIEWER
NAME OF FATHER _____________________________________ OCCUPATION ________________

NAME OF MOTHER ____________________________________ OCCUPATION ________________

Date of Interview: _____/______
MONTHLY FAMILY INCOME ₱ ____________________________ NO. OF SIBLINGS __________

SOURCE OF EDUCATION FUND

Interviewed by:

FAMILY INCOME SCHOLARSHIP _____________________________________

OTHERS _________________________________________________________________ Name and Signature of Interviewer

DO YOU HAVE RELATIVES IN THE FIELD OF ART? YES NO

IF YES, PLEASE SPECIFY ___________________________________________

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 UNIVERSITIES/SCHOOLS ATTENDED STARTING FROM HIGH SCHOOL DIPLOMA/TITLE/DEGREE YEAR OF GRADUATION

Use this space to explain your choice of major and use extra sheet if necessary. (Minimum 0f 200 words)

I, ______________________________________________________________, hereby certify that all information given

above are correct.

I also grant my consent to the UP System, especially the College of Fine Arts, to carry out its mandate under the 1987
Constitution, the UP Charter, and other laws that the CFA must necessarily process my sensitive personal information.

________________________________ _________________________________________________
Signature of Applicant Name and Signature of Parent/Guardian (if student is a minor)

NOTE: ORIGINAL AND PHOTOCOPY OF DOCUMENTS MUST BE PRESENTED UPON APPLICATION. Original copies will only
be used as reference while photocopies submitted will be the property of CFA and will not be returned.
ONLY APPLICATIONS WITH COMPLETE ATTACHMENTS WILL BE CONSIDERED AND PROCESSED.
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