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Application For Admission: School of Urban and Regional Planning University of The Philippines

This document is an application form for admission to the School of Urban and Regional Planning at the University of the Philippines. The application requests personal information such as name, date of birth, citizenship, education history, work experience, proposed area of study, and references. It informs applicants to include a passport photo and provides spaces to fill in details of their identification, background, qualifications, and plans if accepted into the program.

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Ejay Salenga
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55 views3 pages

Application For Admission: School of Urban and Regional Planning University of The Philippines

This document is an application form for admission to the School of Urban and Regional Planning at the University of the Philippines. The application requests personal information such as name, date of birth, citizenship, education history, work experience, proposed area of study, and references. It informs applicants to include a passport photo and provides spaces to fill in details of their identification, background, qualifications, and plans if accepted into the program.

Uploaded by

Ejay Salenga
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

School of Urban and Regional Planning

University of the Philippines


E. Jacinto St., Diliman, Quezon City 1101 PHILIPPINES

APPLICATION FOR ADMISSION PASSPORT SIZE


PHOTO
WITH NAME TAG
Please check (/) one:  Diploma in Urban and Regional Planning
(Family Name,
 Master of Arts (Urban and Regional Planning)
First Name and
 Doctor of Philosophy (Urban and Regional
Middle Initial)
Planning)

No. ___________
(Do not fill)

1. Name (Please print or use block letters):

Family Name First Name Middle Name Maiden Name (If Married)

A. PERSONAL DATA

2. Date of Birth 3. Place of Birth 4. Citizenship 5. Country of Origin

6. Civil Status 7. Gender 8. Age 9. Religion

10. Present Home Address 11. Tel. No. / E-mail

12. Provincial Home Address and Region 13. Tel. No. / E-mail

Professional Regulation Commission (PRC) Examination


Title of the Examination Date Taken Ranking PRC License No.

B. WORK EXPERIENCE

14. Name of Office and Address 15. Tel No. / E-mail

16. Department 17. Designation 18. Nature of Office  Government

 Private  Others ________


19. Nature of Work (Describe briefly)

20. Describe extensively planning or planning-related experience in the last ten years (Name of Office, Position/Designation,
No. of employees under you, etc.) use separate sheet if necessary:

21. Name other offices where you worked in the last ten (10) years, if any:

Position Name of Office Nature of Work Years

C. ACADEMIC / TRAINING BACKGROUND

22. Diploma / Degree Obtained


Title of Diploma / Date Received Institution/Address Honors
Degree Obtained Received
Secondary

Collegiate

Graduate

23. Fellowship Awards (State nature, awarding institution, date and place of award)

24. Training Programs attended (Only in the last 5 years):

25. Title of Undergraduate Thesis 26. Title of Postgraduate Thesis

27. Publication/s (In the last 10 years)


D. PROPOSED PLAN OF STUDY

28. Describe briefly the relevance of DP / M.A. / Ph.D. program to your career plans and objectives.

29. Program Option  Full-time (For M.A. applicants only)  M.A. Thesis

 Part-time  M.A. Non-Thesis

30. Financial Support :  Self Supporting  Parents

 Agency Scholar  Others (Specify) ________________________

E. REFERENCES

31. List the names, positions, offices and addresses of two or more persons whom you asked to fill up the attached reference forms.

Name Position Office and Address

Have you ever been convicted of any crime or violation of any law, decree, ordinance, or regulation by any court or tribunal?
 YES  NO

I hereby affirm that all information supplied herein is complete and accurate. 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 Philippine.

Signature: _____________________________________ Date: ____________________________

(Do Not Fill)

U.P. OR No.: ______________________ Date of Payment: ____________________

Document/s Submitted:

_____ Original/Photocopy Transcript of Records _____ Original/Photocopy Marriage Contract

_____ Undergraduate _____ Four (4) photos

_____ Graduate _____ References

_____ Original/Photocopy Birth Certificate

11 February 2019

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