Application Form valid for SY 2015-16

Application no.
Exam date

Please Paste
RECENT
2x2 ID picture

School Year
Legal name
(Name in Birth Certificate)

Last/Family

First/Given

Middle/Complete

Nickname
Present school
INSTRUCTIONS
1. Read the Admissions Brochure and all instructions carefully.
2. Fill out this form carefully and print or type all information requested. Please do not abbreviate. Write N/A if the information is not
applicable to you. Omissions can delay the processing of your application.
3. Please make sure to complete all the requirements in order to facilitate the processing of your application.
4. Submit this form together with the following: (a) Secondary school record form, (b) Guidance counselor recommendation form,
(c) Personal essay (printed on a short bond paper), (d) NSO- authenticated Birth Certificate,(e) three 2x2 ID pictures (identical with
white background and name printed at the back) and (f) Accomplished Scholarship form for those applying for grants.
5. The Application fee is non-refundable.
*All credentials, including the application form submitted to the University Admissions Office, become property of the school.

PERSONAL INFORMATION
Complete permanent address (Foreign students should specify their address at their country of origin)
Zip code
Mailing address

(if not the same as above)

Telephone number

Zip code
Fax number

E-mail address

Mobile number

Birth date

/
(mm)

Citizenship

/
(dd)

Place of birth
(yyyy)

Filipino

Others (pls. specify)

Dual (pls. specify)

If married, name of spouse

(submit a copy of your marriage contract)

Does your family own a business?

Yes

If yes, specify name and nature of business

No

Religion

Female
Male

FAMILY INFORMATION
Father's name

Mother's name

Last/Family

First/Given

Middle

Last/Family

First/Given

Name of company/ employer

Name of company/ employer

Present occupation/ position

Present occupation/ position

Address

Address

Business phone (

Mobile

Business phone (

Area Code

Middle

Mobile

Area Code

Email Address

Email Address

College (if any)

College (if any)

Degree

Year

Graduate school (if any)

Degree

Year

Graduate school (if any)

Degree

Year

Degree

Year

Sibling/s' educational attainment (eldest to youngest)

Name

Age

Highest educational attainment

Last school attended

1
2
3
4
5

SCHOLASTIC INFORMATION
List all honors and awards you have received for academic excellence and co-curricular activities in high school.
Indicate when you received these.

List all the co-curricular organizations you have participated in. Indicate the position(s) held and year level(s)
when you were in office. (ex. Dramatics Club: Member I, II, Vice President-III; President- IV)

What special training program(s) or seminar(s) have you attended?

Have you failed any subject(s) in high school or college at the end of a term?
If yes, please indicate the failed subject(s), year level(s), and reasons.

Have you repeated a year in high school?

Yes

No

Yes

No

Which year level? Why?

Have you ever been forced to stop schooling for at least a month because of health reasons?
If yes, please give details.

Yes

Please explain any gaps in school history, i.e. times you were not enrolled in any school. (if employed, please
submit a certification of employment)

Were you ever dismissed, suspended or placed under disciplinary probation?

If yes, please indicate offense(s) and sanction(s).

Yes

No

List all your sports, hobbies, interests, special skills and talents.

On a short bond paper, type an essay that conveys your interests (visual/ theater arts, sports, music, gourmet
cooking, etc.), accomplishments; family, educational, entrepreneurial, and social experiences; future goals,
including your strengths, weaknesses and your potentials which will positively contribute to the development of
the University (maximum of 250 words).

No

PROGRAM PREFERENCE
In the boxes provided, indicate your preferred course by writing 1 and 2 respectively.
Seven-Year Program
Juris Doctor in Seven Years
Five-Year Programs
Bachelor of Science in Industrial Engineering
Master of Arts in Humanities
Master of Arts in Political Economy
with Specialization in International Relations & Development
Master of Science in Industrial Economics
Master of Arts in Communication
Major in Integrated Marketing Communications
Master of Science in Management
Four-Year Programs
Bachelor of Science in Entrepreneurial Management
Bachelor of Science in Applied Mathematics
Bachelor of Science in Business Administration
Major in Management
Bachelor of Science in Business Administration
Major in Management with Specialization in Business Analytics
Bachelor of Science in Child Development and Education
Bachelor of Science in Information Technology
Bachelor of Arts in Humanities
Bachelor of Arts in Economics
Bachelor of Arts in Political Economy
Bachelor of Arts in Integrated Marketing Communications
Bachelor of Science in Human Capital Development
Bachelor of Arts in Media and Entertainment Management

Note:
Applicants to the Entrepreneurial Management Program have to take a diagnostic exam for an additional
fee of P250.00
CERTIFICATION

I hereby certify that I have read and fully understood all instructions regarding my application for admissions at
UA&P and that the information supplied in this application and the documentation supporting it are correct and
complete. I understand that incomplete or inaccurate information could be prejudicial to my admission. If accepted
as a student of the University of Asia and the Pacific, I agree to abide by all its policies and regulations.

APPLICANT'S SIGNATURE

DATE
UPDATED August 7 2014