TUP FORM 1-A (revised Aug 2017)

Technological University of the Philippines

OFFICE OF THE REGISTRAR
Taguig

APPLICATION FOR ADMISSION / SCHOLASTIC AND TECHNICAL APTITUDE TEST

Applicant Number: 2021A27072 Classified As:

QUIAMBAO NANIDREF ALONZO

LAST NAME FIRST NAME MIDDLE NAME

HOME ADDRESS
1047 purok 3 Cuyab San Pedro Laguna
No. Street Barangay/District Municipality/City

Direction: On the space provided, please write 1 if it is your 1st choice and 2 if it is your 2nd choice.

BACHELOR OF ENGINEERING & ALLIED

DEPARTMENT
Bachelor of Engineering Technology major in
Electromechanical Technology (Non-Stem)
Bachelor of Engineering Technology major in
Instrumentation & Control Technology (Stem &
Non-Stem)
Bachelor of Engineering Technology major in
Mechatronics Technology (Stem & Non-stem)

BASIC ARTS & SCIENCES DEPARTMENT

Bachelor of Technical Vocational Teacher Education
major in Electrical Technology
Bachelor of Technical Vocational Teacher Education
major in Electronics Technology
Bachelor of Technical Vocational Teacher Education
major in ICT - Computer Hardware
Bachelor of Technical Vocational Teacher Education
major in ICT - Computer Programming

CIVIL & ALLIED DEPARTMENT

Bachelor of Engineering Technology major in Chemical
Technology (Non-Stem)
Bachelor of Engineering Technology major in Chemical
Technology (Stem)
Bachelor of Engineering Technology major in Civil
Technology (Stem)
Bachelor of Science in Civil Engineering - Straight
Engineering Program
Bachelor of Science in Environmental Science - Straight
Degree Program

ELECTRICAL & ALLIED DEPARTMENT

Bachelor of Engineering Technology major in Electrical
Technology (Non-Stem)
Bachelor of Engineering Technology major in Electronics
Technology (Non-Stem)
Bachelor of Science in Electrical Engineering - Straight
Engineering Program
Bachelor of Science in Electronics Engineering - Straight
Engineering Program
Bachelor of Science in Information Technology (Non-
Stem)
Bachelor of Science in Information Technology (Stem)

MECHANICAL & ALLIED DEPARTMENT

Bachelor of Engineering Technology major in Automotive
Technology (Non-Stem)
Bachelor of Engineering Technology major in Dies &
Moulds Technology (Non-Stem)
Bachelor of Engineering Technology major in Heating,
Ventilation and Airconditioning/Refrigeration Technology
(Non-Stem)
Bachelor of Engineering Technology major in Mechanical
Technology (Stem)
Bachelor of Engineering Technology major in Non-
Destructive Testing Technology (Stem)
Bachelor of Science in Mechanical Engineering - Straight
Engineering Program
 PERSONAL DATA

Last Name QUIAMBAO Sex Male Civil Status Single

First Name NANIDREF Contact no. +63 956-8869-839
Middle Name ALONZO Extension Name(Jr., III): E-mail add: nanidrefq02@gmail.com
Citizenship FILIPINO Facebook Account: Nanidref Alonzo Quiambao
Religion Roman Catholic Place of Birth Putatan, Muntinlupa City
Date of Birth 08/29/2001 Height 150 Weight 35
Permanent Address 1047 purok 3 Cuyab San Pedro Laguna
Means of financial Support: Parents Scholarship Others

FAMILY BACKGROUND

Father's Name Ferdinand Vierneza Quiambao Mother's Name Lailani Alonzo Quiambao
Contact No. NA Contact No. NA
Occupation Carpentry Occupation housewife

Name of Guardian Lailani Alonzo Quiambao

Complete Address 1047 Purok 3 Brgy. Cuyab San Pedro
Contact No. NA
Relationship Mother

EDUCATIONAL ATTAINMENT

School Last Attended (Secondary/Tertiary): San Pedro College of Business Administration

School Address: San Pedro, Laguna
Exclusive Years/Attended 2020 Honor/Distinction
Grade 11/12 GWA: 88.00 MATH: 84.00 SCIENCE: 89.00 ENGLISH: 89.00
TRACK: Science, Technology, Engineering and Mathematics
Category: K-12 Old Curriculum With College Background

EMPLOYMENT BACKGROUND

Name of
Position: Inclusive Dates:

PLEDGE

I HEREBY AFFIRM THAT ALL THE ANSWERS GIVEN HERE ARE TRUE AND CORRECT. I UNDERSTAND THAT GIVING FALSE
INFORMATION WILL AUTOMATICALLY DISQUALIFY ME FOR ADMISSION OR SUBJECT TO DISMISSAL BY COMPETENT AUTHORITIES.
ADMITTED, I WILL ABIDE AND COMPLY WITH ALL THE POLICIES, RULES AND REGULATIONS OF THE TECHNOLOGICAL UNIVERSITY
OF THE PHILIPPINES

CERTIFIED CORRECT:

Signature of Student

============================================= Do not write on this area =============================================

Course Code BETCT-T Application No. 2021A27072
Date of Examination Official Receipt
Time Room O.R. Date