...VALID ONLY FOR UPCAT 2013 UPCAT Form 1 (Rev. 3-2012) TO BE FILLED OUT ONLY BY PERSONNEL AUTHORIZED TO RECEIVE AND/OR PROCESS APPLICATIONS. Document Inventory Number UNIVERSITY OF THE PHILIPPINES UPCAT APPLICATION FOR FRESHMAN ADMISSION FIRST SEMESTER AY 2013-2014 TO THE STUDENT AND PARENTS/GUARDIAN: Carefully read the GENERAL INFORMATION BULLETIN ON FRESHMAN ADMISSION before filling out this application form. Testing Fee: P450 US$50 US$100 Exempted : TOP 10 INCOME Deficiency/cies: List of Top 10 across all curricular programs/annexes BIR Certificate / ITR / Cert of Compensation 2316 Testing Fee F2 OTR GP/GR Affidavit PEPT GCSE/GCE Passport NBCR/ICR Remarks: Print legibly all information required. Place X marks in appropriate boxes. Only accomplished application forms, UPCAT Form 1 and UPCAT Form 2 (Secondary School Record) will be processed. 1. Received by Exemption Evaluator TP Checker NAME OF STUDENT: Print or type your full name in the following sequence: LAST NAME, FIRST NAME, MIDDLE NAME. Place one letter in each box. Leave one box blank between names. LAST Staple here FIRST S taple a recent 2" X 2" photograph (taken within the last six months) in this box. MIDDLE 2. SEX 1 Male 2 3. DATE OF BIRTH (Month, Day, Year) 4. PLACE OF BIRTH (City/Town, Province) 5. MEMBER OF CULTURAL MINORITY GROUP? 2 6. CITIZENSHIP 1 2 7. Female - Be sure to print your name at the...
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