Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES Control #________

University Town, Northern Samar
Web: http://uep.edu.ph ; Email: uepnsofficial@gmail.com

Office of the Director for Admission

EXPRESSION OF INTENT FOR ADMISSION

(Form 1; Freshman Applicant)

Date
Last Name
First Name
Middle Name
Birthday
Cellphone Number
E-mail Address
Home Address
Senior High School Strand
Senior High School
Senior High School Address
To the Admissions Committee
I would like to express my interest in pursuing my application for admission in any of the
following programs offered by the University of Eastern Philippines
First preference: ________________________________________________
Second preference: ________________________________________________
Third preference: ________________________________________________
Fourth preference: ________________________________________________
Fifth preference: ________________________________________________
Signature of over Printed Date
Name of Applicant
Signature of over Printed Date
Name of Parent/Guardian

Important Reminders

1. This form must be completely accomplished and signed. Write legibly.

2. Upon completion, this form must be enclosed in a long brown envelope together with the other admission documents
(authenticated/photocopies only) and submitted to the Office of the Director for Admission, through the University
Link on or before 31 December 2021. Late submission will no longer be entertained.
3. The admission of the student to the program of choice will be subject to the final decision of the Admissions
Committee, based on the academic requirements and the availability of slots in the specific degree program.
Submission of this form is not a guarantee for admission.
4. Confirmation of admission status will be done through phone call/text, email, and announcement thru the UEP –
Office of the Director for Admission FB Page and public postings on the college bulletin boards within the UEP Main
Campus premises.
5. Once submitted, the documents will become office property and will no longer be returned to the applicant.
Control #________
 Republic of the Philippines
UNIVERSITY OF EASTERN PHILIPPINES
University Town, Northern Samar
STUDENT PERSONAL
Web: http://uep.edu.ph DATA SHEET
; Email: uepnsofficial@gmail.com
(Form 2)
Office of the Director for Admission
Date
Last Name
First Name
Middle Name
Sex Age Civil Status
Home Address

Street Barangay Municipality/City Province

Birthday Birthplace
Citizenship Religion
Height (m) Weight (kls) Blood Type
Cellphone Number e-mail address
Senior High School (SHS)
SHS Strand
Date of SHS Graduation
SHS Address
Last University/College attended (for transferees)

Address of Last University/College attended

Father’s Name Occupation

Mother’s Maiden Name Occupation
Parents’ Address
Person to be contacted in case of
emergency
Relationship Contact Number

2 x 2 ID
_________________________________
Student’s Signature

ESSAY
(Form 3)