F-CPD-004 Rev 3 (07/31/11)
COLLEGE ENTRANCE TEST APPLICATION FORM
[ ] Manila [ ] Makati [ ] Cavite
2x2
STATUS (TO BE FILLED OUT BY AIC): ___ NG ___ GPSY
___T1
___T2 ___FS
___OTHERS:
LAST NAME : FIRST NAME : MIDDLE NAME:
Type or print clearly. Complete the application form correctly. Place N. A. when Not Applicable.
AGE: GENDER (M/F): CIVIL STATUS : TEL. NO: MOBILE NO:
______________________ BATCH CODE: ______________________ SCHOOLYEAR: ______________________ SEMESTER : ______________________ CITIZENSHIP: ______________________ EMAIL ADDRESS :
_____________________________ _____________________________ [ ] 1ST [ ] 2ND [ ] SUMMER _____________________________ _____________________________
COURSE PREFERENCES. Indicate the courses that you want to apply for by numbering 1 to 3 in the appropriate boxes below:
ARTS AND SCIENCES AB Journalism AB Legal Studies AB Multimedia Arts BUSINESS ADMINISTRATION BS Accountancy BS Customs Administration BSBA Management Accounting BSBA Marketing Management BSBA Operations Management BSBA Business Management INTERNATIONAL TOURISM & HOSPITALITY MANAGEMENT INTERNATIONAL RELATIONS BS Psychology AB Foreign Service Diploma cy International Trade NURSING BS Nursing BS International Hospitality Management BSIHM - Hotel & Restaurant Administration BSIHM - Culinary Arts & Kitchen Operations BSIHM - Cruise Line Operations in Hotel Services BSIHM - Cruise Line Operations in Culinary Arts BSIHM Health and Wellness COMPUTER STUDIES BS Computer Science BS Information Technology BS Information Systems Associate in Computer Technology
AB Mass Communication Advertising Broadcast Comm.
ENGINEERING BS Computer Engineering BS Electronics Engineering BS Electrical Engineering
BS International Travel & Tourism Management
FOR TUITION FEE DISCOUNTS:
1. 2.
Are any of your parents alumni of LPU? ___ YES ___ NO If so, who? ___ Mother ___Father If YES, Kindly indicate: NAME : ______________________ DEGREE: __________________ YEAR GRADUATED: ________
Do you have any siblings currently enrolled in LPU? ___ YES ___ NO (If YES, Kindly indicate their NAME, YR LEVEL and PROGRAM
_______________________________________________________________________________________________________________________ I hereby certify that the information on this application is true and correct. (If REPRESENTATIVE, signature over printed name) __________________________________________ APPLICANTS SIGNATURE DO NOT WRITE BELOW THIS LINE Relation to the applicant: ______________________
APPLICATION STATUS : ____ APPROVED ____ CONDITIONAL REMARKS : __________________________________ CREDENTIALS PRESENTED : ____ FORM 138 ____ GMC ____ CCG ____ BC ____ TCG ____ TOR ____ HD/TC OTHERS : _________________________________________________________________________________ PROCESSED BY : _____________________ DATE : ___________________ AMOUNT TO BE PAID : __________________ REMARKS : _____________________________________________________________________________________________ The primary function of education is to develop all potentialities of the individual Dr. Jose P. Laurel, Founder of LPU
