POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

ADMISSION AND REGISTRATION SERVICES

CAEPUP 2023 STO. TOMAS, BATANGAS

CAEPUP 2022 APPLICATION FORM

REFERENCE NUMBER: 2023-0065-5121 DATE OF APPLICATION: 02/14/2023
PERSONAL INFORMATION:
Complete Name: Cañales, Jovy-Ann Villamera
Sex: FEMALE Height: 156 cm. Date of Birth: 10/19/2004

Civil Status: SINGLE Weight: 71 kg

CONTACT INFORMATION:
Contact Number/s: 09977339897
Email Address: jovy-ann.canales@shsinmalvar.org
Address: 1157 Darasa Tanauan Batangas, Brgy. Darasa, CITY OF TANAUAN, Philippines (the)

IN CASE OF EMERGENCY, Please No fy:

Contact Number/s: 09659651681
Contact Person: Susana Cañales
Address: 1157 Darasa Tanauan Batangas, Brgy. Darasa, CITY OF TANAUAN, Philippines (the)

ACADEMIC INFORMATION (LAST SCHOOL ATTENDED):

Mode of Learning: Senior High School LRN 107478120025

School Name: Malvar Senior High School

School Address: Poblacion, Malvar Batangas
Year Graduated: 2023

EMPLOYMENT INFORMATION (OPTIONAL):

Company: Not Employed Contact Number/s: Not Applicable

Address: Not Applicable

ACADEMIC PROGRAM PREFERENCES:

1. BSPSY-ST-BACHELOR OF SCIENCE IN PSYCHOLOGY (STO. TOMAS)

2. DOMTLOM-ST-DIPLOMA IN OFFICE MANAGEMENT TECHNOLOGY WITH SPECIALIZATION IN LEGAL OFFICE MANAGEMENT (STO. TOMAS)

3. DIT-ST-DIPLOMA IN INFORMATION TECHNOLOGY (STO. TOMAS CAMPUS)

4. BTLEDICT-ST-BACHELOR OF TECHNOLOGY AND LIVELIHOOD EDUCATIONS MAJOR IN INFORMATION AND COMMUNICATION TECHNOLOGY (STO.

5. BPAPFM-ST-BACHELOR OF PUBLIC ADMINISTRATION MAJOR IN PUBLIC FINANCIAL MANAGEMENT (STO. TOMAS)

CONFORME:

APPLICANT’S SIGNATURE DATE

- - - - - - - - - TO BE FILLED UP BY AN AUTHORIZED PUP ADMISSION OFFICER - - - - - - - - -
REMARKS:

THIS IS AN AUTO-GENERATED COPY OF YOUR CAEPUP 2022 APPLICATION FORM • VOID IF TAMPERED • VALID ONLY For the First Semester, Academic Year 2023-2024
THIS FORM CONTAINS PERSONALLY IDENTIFIABLE INFORMATION. TO PROTECT YOUR DATA PRIVACY, PLEASE KEEP AND FILE THIS IN A SAFE LOCATION.
TRANSACT AND SUBMIT ONLY TO AN AUTHORIZED PUP ADMISSION OFFICER.

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