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QE APplication Form 5

The document is an application form for a qualifying examination at a university in the Philippines. It requests personal information from applicants and contains instructions for taking the exam such as bringing identification, materials, and arriving on time. Examinees must follow the rules or risk forfeiting their examination.

Uploaded by

Jojimar Julian
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
19 views1 page

QE APplication Form 5

The document is an application form for a qualifying examination at a university in the Philippines. It requests personal information from applicants and contains instructions for taking the exam such as bringing identification, materials, and arriving on time. Examinees must follow the rules or risk forfeiting their examination.

Uploaded by

Jojimar Julian
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
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Republic of the Philippines

PASTE HERE
UNIVERSITY OF RIZAL SYSTEM
PASSPORT SIZE PHOTO
In plain white background Province of Rizal
(taken within 3 months)

Scanned/ Photocopied
Picture not acceptable
COLLEGE OF EDUCATION

QUALIFYING EXAMINATION APPLICATION FORM


CAMPUS FIRST CHOICE (Check ✓ your current program) SECOND CHOICE (Check ✓ your alternative program)
▢ ANGONO ▢ RODRIGUEZ ▢ ENGLISH ▢ HOME ECONOMICS ▢ ENGLISH ▢ HOME ECONOMICS

▢ ANTIPOLO ▢ PILILLA ▢ FILIPINO ▢ INDUSTRIAL ARTS ▢ FILIPINO ▢ INDUSTRIAL ARTS

▢ CAINTA ▢ TANAY ▢ MATHEMATICS ▢ ICT(Information and ▢ MATHEMATICS ▢ ICT(Information and


Communication Technology) Communication Technology)

▢ MORONG ▢ TAYTAY ▢ SCIENCE ▢ DRAFTING TECHNOLOGY ▢ SCIENCE ▢ DRAFTING TECHNOLOGY

▢ SOCIAL STUDIES ▢ CONTENT COURSE ▢ SOCIAL STUDIES ▢ CONTENT COURSE


BEEd

WARNING: This application form must be filled out personally by the applicant. All documents submitted shall form part of the records of the College and are subject to
verification. Any false statement or misrepresentation made in this application is a ground for disqualification and administrative sanction for falsification. PERSONAL
APPEARANCE SHALL BE REQUIRED IN THE FILING OF THIS APPLICATION.

PERSONAL INFORMATION
LAST NAME FIRST NAME MIDDLE NAME

PERMANENT ADDRESS (House Number, Street, Town, Province/ City)

SEX ▢ MALE ▢ FEMALE CONTACT NUMBER/S


(Landline/Mobile)

CIVIL STATUS ▢ SINGLE ▢ MARRIED DATE OF BIRTH PLACE OF BIRTH (City, Town Province)

I HEREBY CERTIFY that the information and/ or statements in this application including the exhibits submitted in support thereof are all true and correct of my own knowledge,
and that I am fully aware that any false information or statement in this application or its attachments shall render me liable for administrative sanction.

____________________________________________________ ___________________________________
Signature over Printed Name of Applicant DateofofApplication
Date Applicant

Republic of the Philippines


UNIVERSITY OF RIZAL SYSTEM
PASTE HERE Province of Rizal

PASSPORT SIZE PHOTO APPLICATION STUB (This also serve as your Notice of Admission)
In plain white background
(taken within 3 months)
NAME(Surname, Given Name, Middle Initial):
Scanned/ Photocopied
Picture not acceptable FIRST CHOICE: SECOND CHOICE:

ACKNOWLEDGEMENT OF THE RECEIPT OF TEST BOOKLET & ANSWER SHEETS


I acknowledge receipt of the test booklet and answer sheets of the above - named examinee on the subjects indicated below:

PROCTORS SIGNATURE DATE

FIRST CHOICE

SECOND CHOICE

GENERAL INSTRUCTION TO EXAMINEE:


1. On the day of the examination, report to the room assignment not later than _____, 4. You will not be allowed to leave the examination room, borrow anything or
be punctual. Late examinees will not be admitted. Examination Fee of ABSENT communicate with other examinees on any matter during the examination.
EXAMINEE/S will be forfeited.

2. Identification Card (ID) is required. 5. You are not allowed to bring food and eat inside the room.

3. Bring the following on examination day: Application Stub, Official Receipt of payment 6. Non - compliance with the general instructions shall be ground for forfeiture/
of application for examination, One (1) brown envelope, One (1) transparent plastic cancellation of your examination
envelope, Two or more Pencils (No. 2), Ballpen with black ink only, and 1pc. Passport
size photo.

NOTE: Failure to Submit the Evaluated Application Form to the College Dean will exclude the Application from the list of Examinees and the Amount Paid shall be forfeited.

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