Instructions to Applicant:

o Application form with Incomplete Requirements/ Documentation will not be accepted

o Birth Certificate from National Statistics Office (for Filipino Citizens)
o Official Transcript of Records (OTR)
o Test of English as a Foreign Language (TOEFL) results of Certification that the medium of
instruction is English (from the University you graduated) for Foreign Applicants whose native
language is English
(attached passing score)
TOEFL Score : Computer based = 173 ,
Internet based = 61 ,
Paper based = 500.

Note : All the above requirements will be submitted to the Office of the University Registrar (OUR) upon
issuance of the Admission Slip (for admitted applicants)

Deadline for Filing Application: Please refer to the College of Science website (www.science.upd.edu.ph) for
the updated schedule.

SCHEDULE OF CLASSES MAY INQUIRE AT THE SPECIFIC INSTITUTES/ PROGRAM YOU ARE
APPLYING/ ADMITTED.
CS-GO Form No. 1 (Rev. 09-2015)
THE GRADUATE OFFICE
COLLEGE OF SCIENCE
UNIVERSITY OF THE PHILIPPINES
Diliman, 1101 Quezon City
Philippines
www.science.upd.edu.ph

APPLICATION FOR ADMISSION TO A GRADUATE PROGRAM

(Use additional sheets if necessary)

Instructions to Applicant:

1. Complete and arrange this form in duplicate. Type or print clearly.

2. Submit the following:

a.) Formal letter of application addressed to the Dean,

College of Science, University of the Philippines, Attach 2 x 2
Diliman, Quezon City (original and photocopy)
Photograph
b.) Pay cash at the U.P. Cashier or postal money order for P500 or
$25 bank draft (for foreign applicants) application fee, payable to
the University of the Philippines

c.) Official transcripts of undergraduate and graduate

records (2 photocopies)

d.) Certified copies of diplomas or certificates of graduation

(2 photocopies)

Name: Ms/Mr. _____________________________________________________________________________________

(Last) (First) (Middle/Maiden)

Email Address : __________________________________________ Cell phone No. : ____________________________

Mailing Address: ____________________________________________________________________________________

________________________________________________________ Tel. No.: __________________________________

(State or Region) (Country)

Permanent Address: _________________________________________________________________________________

________________________________________________________ Tel. No.: _________________________________

(State or Region) (Country)

Age: _________________________ Sex: ________________________ Civil Status: _________________________

Date of Birth: ____________________________________ Place of Birth: ____________________________________

Month/Day/Year
Citizenship: ______________________________________ Nationality: _____________________________________

Graduate Degree Program Applied for:* _________________________________________________________________

Proposed Start of Graduate Study: [ ] 1st Semester [ ] 2nd Semester AY _____________________________

Source of Financial Support: __________________________________________________________________________

Are you applying under a special arrangement or scholarship program? (If yes, indicate
collaborating university or funding agency) _______________________________________________________________

*Please refer to the list of graduate degree programs offered by the College of Science
Have you applied to any other graduate program at any other time? (If YES, indicate
university, field of study, semester and year) _______________________________________________________

__________________________________________________________________________________________________

Academic Background (from secondary school to highest university education):

Name and Address of School Inclusive Dates Degree Honors

(month & year) Completed Obtained

Academic Honors, Awards, Scholarships:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Membership in Learned Societies or Professional Organizations (indicates positions held, if any):

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Work Experience (list in chronological order)

Name and Address of Employer Inclusive Dates Position Held Nature of Job
(month & year)

Scientific and technical papers published or presented in scientific meetings:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________
 STATEMENT OF PURPOSE

Write a clear and concise essay of not more than 300 words on your purpose in applying to this graduate
program and your plans for graduate study, if admitted. Include your specific area/areas of interest, an assessment of
your academic, mental, and emotional preparedness for graduate study, and your future prospects.
 REFERENCES

(Name at least two former professors or experts in your field whom you think are capable of objectively
evaluating your past performance and potential for success as a graduate student and professional in your chosen field.
Request these persons to complete the enclosed recommendation form, CS-GO Form No. 2(86).

1) Name: _____________________________________________________________________________________

Degree and Field of Specialization: ______________________________________________________________

Position: ___________________________________________________________________________________

Name and Address of Organization: _____________________________________________________________

(2) Name: _____________________________________________________________________________________

Degree and Field of Specialization: ______________________________________________________________

Position: ___________________________________________________________________________________

Name and Address of Organization: _____________________________________________________________

(3) Name: ______________________________________________________________________________________

Degree and Field of Specialization: _______________________________________________________________

Position: ___________________________________________________________________________________

Name and Address of Organization: ______________________________________________________________

I hereby affirm that all the above information is complete and accurate. I know that any false or misleading
information given by me can make me ineligible for submission or subject to dismissal. If admitted, I agree to abide by
the policies, rules, and regulation of the University of the Philippines.

_______________________ _______________________________________
Date Signature of Applicant

_______________________________________
Printed Name