PERSONAL INFORMATION

Name:
JUAN REYES DELA CRUZ

Nickname: Honorifics:
JUAN MR. 2x2 FORMAL PICTURE

Gender: Pronouns:
CISGENDER MAN HE/HIM

Date of Birth: Student Number:

1 JANUARY 2000 2000-10000-MN-0

Locality:
For Campuses: Indicate what campus you came from. (e.g., PUP LOPEZ)
For Main Campus: Indicate what college or institute (e.g. PUP COLLEGE OF SCIENCE)

Program Year Section:

BACHELOR OF SCIENCE IN CIVIL ENGINEERING (BSCE) 4-1

CONTACT INFORMATION

Mobile Number: Facebook Name:

0900 000 0000 Juan Dela Cruz

Email: Instagram Username:

juandelacruz@gmail.com @juandelacruz

Webmail: X (formerly Twitter) Username:

juanrdelacruz@iskolarngbayan.pup.edu.ph @juandelacruz

Home Address:
00 Anonas St., Sta. Mesa, City of Manila

LEADERSHIP BACKGROUND

Position, Organization Year Biggest Contribution

Junior Council Officer, PUP Sentral 2023-present Catered student concerns.

na Konseho ng Mag-aaral

Chairman, Sangguniang Kabataan 2023-present Lead the council.

ng Brgy. Bato

Vice President for External 2021-2023 Respond to external

Affairs, DEFLL Book Lovers communications.
Club
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Delete this row if it is not applicable.

TOP 2 DEPARTMENT/COMMITTEE CHOICES

NOTE: In the case of applicants for the Creatives and Engagement Department, specify your specialization in
either publicity materials or captions. Additionally, kindly include a minimum of two (2) original copies of publicity
materials or captions that you have crafted in previous engagements in the appendix section at the end.

Rank Department/Committee

1 CREATIVE AND ENGAGEMENT DEPARTMENT

* Change all those highlighted in yellow; answer in all bold. Delete all those highlighted in green.
* For questions, send them to ofcstudentregent@pup.edu.ph.
 2 GENDER AND SAFE SPACE COMMITTEE

REQUIREMENTS SWEAR OF OATH

● Letter of Intent “I hereby certify that the facts that are stated herein are true
● Application Form and correct to the best of my knowledge.”
● Sample of original publicity materials or
captions for Creatives and
Engagement Department Applicant
only.
● Proof of Enrollment X
● 2x2 Photo JUAN REYES DELA CRUZ
SIGNATURE OVER PRINTED NAME

APPENDIX

I. At least two (2) original copies of publicity materials or captions (for Creative and Engagement
Department applicants only)

* Change all those highlighted in yellow; answer in all bold. Delete all those highlighted in green.
* For questions, send them to ofcstudentregent@pup.edu.ph.