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Ucu-Cat Application Form

The document is an admission test application form for Urdaneta City University, detailing the necessary information and requirements for prospective students. It includes sections for personal information, educational background, and consent for data processing. Additionally, it provides a stub for the college admission test permit with reminders for examinees.

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msamilin758
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© © All Rights Reserved
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43 views1 page

Ucu-Cat Application Form

The document is an admission test application form for Urdaneta City University, detailing the necessary information and requirements for prospective students. It includes sections for personal information, educational background, and consent for data processing. Additionally, it provides a stub for the college admission test permit with reminders for examinees.

Uploaded by

msamilin758
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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URDANETA CITY

UNIVERSITY CENTER FOR STUDENT PSYCHOLOGICAL ASSESSMENT


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

Bright COLLEGE
future starts
ADMISSION TEST APPLICATION FORM
here
URDANETA
Application for:
CITY
First Semester Second Semester School Year: ______________
Freshman Transferee Second Degree
Passport Size
Last Name: ___________________________________________ Picture
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)

DOCUMENTARY REQUIREMENTS: Course to Enroll


Duly accomplished UCU-CAT Form with Passport-size Picture First Choice: ________________________
HS/SHS Card/Certificate of Rating (For Incoming Freshmen) Second Choice: ______________________
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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