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Registration Form: Tugaoen, Sam Denielle Salvacion

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NMAT

National Medical Admission Test


REGISTRATION FORM
(This Form will NOT be collected on test day)

Application No.: 1032000887 TUGAOEN, SAM DENIELLE SALVACION


Bank Reference No.: 2554791405 Name of Applicant
(Name that will appear on your Answer Sheet and Examinee Report Form)

1997-11-02 Female Philippines Single


Birthdate Sex Nationality Civil Status
#80 E. MARTIN STREET, SANTOLAN, MALABON CITY, METRO MANILA 1478 Philippines
2 X 2 ID Picture Mailing Address (Address where your Examinee Report Form will be delivered)
N/A +63-9261731190 heydenielle@gmail.com
Landline No. Mobile No. Email Address

FOREIGN APPLICANT

Passport No. Expiry Date Place of Issue


Test Location: Manila
Test Date: March 01, 2020

REMINDERS

A. PAYMENT
1. Bring this Registration Form to the nearest BPI or BDO branch. Pay the exact amount of (
PHP1900.00 ) on or before
___________________
December 20, 2019 (Philippine Standard Time). The bank may charge a minimal service fee for the deposit transaction.

2. Make sure to copy the following details in the bank’s deposit slip.
Bank Reference Number :
Merchant Name : Center for Educational Measurement, Inc. (CEM)
Account Number (choose one) : BPI current account number 1881-0450-24
OR
BDO savings account number 0048-8008-5327

3. Confirm the details of your transaction receipt (double-check the bank reference number and account number). Keep the copy of
deposit or transaction slip for future reference.
4. Avoid making payment transactions via ATM, online, or mobile fund transfers. These are NOT traceable to your NMAT
application. You will need to pay the full amount again.
5. A surcharge fee of Php 200.00 will be collected to process refund request due to over or double payment and processing of any special
request or correction.

B. REQUIRED DOCUMENTS
1. Email a pdf file of your Transcript of Records (for graduate applicants) or Certificate to Graduate (for graduating applicants) to
nmatmarch2020@gmail.com
nmatmarch2020@gmail.com using this subject header format: Application Number_Last Name First Name. These
documents will NOT be collected on test day. Failure to do so will disqualify you from taking the NMAT.

C. EXAMINATION PERMIT
1. Visit the official website at least a week before the test date to know your room assignment and to download your Examination Permit.
YOU ARE REQUIRED TO BRING THE EXAMINATION PERMIT TOGETHER WITH A VALID ID ON TEST DAY.

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