Application Fee: University of the Philippines Manila Staple 2 recent 2” x 2” P150 $20 OFFICE OF THE UNIVERSITY REGISTRAR photographs Non-refundable Padre Faura Street, Ermita, Manila O.R. No. ______________ FOREIGN UNDERGRADUATE EVALUATION ADMISSION APPLICATION Please sign GWA_______ ______Semester/AY______ Units_____ photographs Degree_______________ at the back Referred to___________ U.P. Form No. 3.1 (Rev. 11-26-2014) _________________________________________________________________________________ SURNAME/LAST NAME FIRST NAME MIDDLE NAME Date of Birth (mm/dd/yy):______________________________ Civil Status: __________________ Male Female Citizenship: ___________________________ ________________________________________________________________________________ Permanent Address: Present Address: Telephone/Cellphone No. (Area Code)+ Tel. No. ________________________ Email Address:_______________________ NAME OF FATHER__________________________ NAME OF MOTHER_________________________ STATUS: ∏ BEGINNING FRESHMAN (High school graduate with no college unit) ∏ TRANSFER STUDENT (Has taken college courses/graduates from other schools) DEGREE PROGRAMS APPLIED FOR (list according to priority preferably Bachelor of Arts courses) 1.____________________________ 2._______________________ HIGH SCHOOL ATTENDED: _______________________________________________________________ Name of School Location Years attended Date of graduation COLLEGE/S ATTENDED: Name of School Location Sem(s) & Year(s) Degree Pursued Date of Graduation Attended _________________________________________________________________________________ _________________________________________________________________________________ Are all grades for all collegiate subjects enrolled already submitted with this application? ∏Yes ∏No Are you still enrolled in a school outside UP? ∏Yes ∏No Have you ever been subject to academic or disciplinary action (I.e.probation, suspension, dismissal, expulsion) from any institution attended? ∏Yes ∏No If yes, explain by giving the dates and other details: ______________ _________________________________________________________ Examination Taken: Year Taken ____________ IMMIGRATION STATUS: GCE Result/Score: O Level_______ A Level _______ Passport No._____ Date of issue ______ Valid until_____ Type of Visa _____ Date of issue ______ Valid until_____ SAT Result/Score: Verbal ___________ Mathematical _______ ACR/ICR No._____ Date of issue ______ Place ________ Year Taken ______________ For applicants from non-English speaking countries: Date of TOEFL taken _______ Score ________________ Date of TOEFL score sent to UP Manila ______________ I hereby affirm that all information supplied herein are complete and accurate and that all pertinent documents are official, true and correct. Withholding or giving false information will make me ineligible for admission or subject to dismissal. If admitted, I agree to abide by the policies, rules and regulations of the University of the Philippines Manila. _______________________________ ____________________ Signature Date.