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UCU-CAT Application Form

This document is a College Admission Test Application Form for Urdaneta City University for the academic year 2022-2023. It includes sections for personal information, educational background, and required documents, as well as an information consent form regarding the use of personal data. Additionally, it provides details for the examination slip and reminders for applicants regarding the test day requirements.

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thccchckn
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99 views1 page

UCU-CAT Application Form

This document is a College Admission Test Application Form for Urdaneta City University for the academic year 2022-2023. It includes sections for personal information, educational background, and required documents, as well as an information consent form regarding the use of personal data. Additionally, it provides details for the examination slip and reminders for applicants regarding the test day requirements.

Uploaded by

thccchckn
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

URDANETA CITY

UNIVERSITY
Owned and operated by the City Government of Urdaneta
PSYCHOLOGICAL ASSESSMENT
AND COUNSELING CENTER

COLLEGE ADMISSION TEST APPLICATION FORM


A.Y. 2022-2023

Please check: New student Transferee Passport Size


Picture

Last Name: ____________________________________________


First Name: ____________________________________________
Middle Name(If none, write N/A): _____________________________
Civil Status: Single Sex: Male Date of Birth (MONTH/DD/YEAR):
Married Female __________________________
Telephone number: Mobile Number: Email Address:
_________________ __________________ ____________________________
Permanent/Mailing Address: _______________________________________________________________
House No. & Street Barangay Municipality/City Province Zip Code

For HS Graduates: For Transferees:


Name of School Attended: _________________________ School Last Attended: __________________________
SHS Track or Strand: GAS ABM Course: _______________________
HUMMS TVL
STEM
For ALS Graduates:
Name of School Attended: _________________________ Date Taken & Passed: _______________________
Average Rating: ____________________________
Degree Programs Offered: (Please check UCU Website)
https://ucu.edu.ph/ Course:
First Choice: __________________
DOCUMENTS SUBMITTED:
Second Choice:_________________
Duly accomplished UCU-CAT Form
2pcs. Passport Size Picture
Valid ID
HS Card / Certificate of Rating
OTR/Copy of Grades (For Transferees)

INFORMATION CONSENT FORM

I am aware that Urdaneta City University will collect, utilize, transfer and disclose my personal
information for academic placement purposes, and these records will be processed in compliance with
the Data Privacy Act of 2012.
I hereby give my consent that my personal data may be used by Urdaneta City University for the
processing of my application for College Admission Test.
Signed by: _________________________ _______________________ Date: _________
Signature over printed name of the Applicant Signature over printed name of
Parent/ Guardian of the applicant

Received and Checked by: ______________________________ Date: _________


Counselor-in-charge

COLLEGE ADMISSION TEST EXAMINATION SLIP


Date: ____________________________
Examinee No. _____________________
Name: __________________________________________________________________ Passport Size
LAST NAME FIRST NAME MIDDLE NAME Picture
Date & Time of Examination: _______________________ Testing Room: _______________

REMINDERS
• Bring your examination Permit, black pencil and ballpen on the scheduled date and time of
examination.
• Get results from the Guidance Office as scheduled. ______________________________
Counselor-in-charge

Bright future starts here

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