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    UCU-CAT APPLICATION FORM 1st Semester 2024-2025

    Uploaded by

    John Mark Daryll Claveria

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    UCU-CAT APPLICATION FORM 1st Semester 2024-2025

    Uploaded by

    John Mark Daryll Claveria
    142 views1 page

    Original Title

    UCU-CAT APPLICATION FORM 1st Semester 2024-2025 (3)

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    142 views1 page

    UCU-CAT APPLICATION FORM 1st Semester 2024-2025

    Uploaded by

    John Mark Daryll Claveria

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    URDANETA CITY

    UNIVERSITY CENTER FOR STUDENT PSYCHOLOGICAL ASSESSMENT


    Owned and operated by the City Government of Urdaneta LEADERSHIP AND DEVELOPMENT AND COUNSELING CENTER

    Bright future starts


    here
    COLLEGE ADMISSION TEST APPLICATION FORM
    st
    1 Semester, A.Y. 2024-2025
    URDANETA CITY
    Passport Size
    Please check: New student Transferee Picture

    Last Name: ___________________________________________


    First Name: ___________________________________________
    Middle Name (If none, write N/A): _______________________________
    Civil Status: Single Sex: Male Date of Birth (MM/DD/YEAR):
    Married Female ___________________________________________
    Telephone number: Mobile Number: Email Address:
    ________________________ __________________________ ________________________________________
    Permanent/Mailing Address: _______________________________________________________________
    House No. & Street Barangay Municipality/City Province Zip Code

    For HS/SHS Graduates: For Transferees:


    Name of School Attended: _________________________________ School Last Attended: __________________________
    SHS Track or Strand: GAS ABM HUMMS TVL STEM Course: __________________________________

    For ALS Graduates


    Name of School Attended: _________________________ Date Taken & Passed: _______________________
    Average Rating: ____________________________
    Degree Programs Offered: (Please check UCU Website: https://ucu.edu.ph/courses-offered)
    Course to Enroll
    DOCUMENTARY REQUIREMENTS:
    First Choice: ________________________
    Duly accomplished UCU-CAT Form with Passport-size Picture
    Second Choice: ______________________
    HS/SHS Card/Certificate of Rating (For Incoming Freshmen)
    OTR/Copy of Grades (For Transferees)
    Valid ID

    INFORMATION CONSENT FORM


    I am aware that Urdaneta City University will collect, utilize, transfer and disclose my personal information for academic
    placement purposes, and these records will be processed in compliance with the Data Privacy Act of 2012.
    I hereby give my consent that my personal data may be used by Urdaneta City University for the processing of my application
    for College Admission Test.
    _________________________ _______________________ Date: _________
    Signature over printed name of the Applicant Signature over printed name of
    Parent/ Guardian of the applicant
    Received and Checked by: ______________________________ Date: _________
    Counselor-in-charge

    COLLEGE ADMISSION TEST PERMIT STUB

    Date: ____________________________
    Examinee Number: _________________
    Name: __________________________________________________________________ Passport Size
    LAST NAME FIRST NAME MIDDLE NAME
    Picture
    Date & Time and Examination: __________________ Testing Room: ______________

    REMINDERS
     Bring your examination Permit, black pencil on the scheduled date and time of examination.
     Get results from the Guidance Office as scheduled.

    ______________________________
    Counselor-in-charge

    Bright future starts here

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