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Application Form-Masters in Political Economy This box to be filled in by SLG personnel

Application No. :___________________________________ Interview Date: __________________

INSTRUCTIONS: 1. Submit two (2) copies of this form to the School of Law and Governance together with one (1) copy of the following attachments:

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Official transcript of records of undergraduate course (original) Curriculum vitae Photocopy of college diploma For non-UA&P graduates: Prospectus showing course descriptions of undergraduate course Proof of payment of application fee of PHP 1,500

2. Fill out this form completely, leaving no item blank (indicate “NA”if not applicable to you). INCOMPLETE FORMS AND FORMS WITH INCOMPLETE ATTACHMENTS WILL NOT BE ACCEPTED. PERSONAL INFORMATION

Name: ______________________________________________________________________________________________________ LAST NAME FIRST NAME MIDDLE NAME NICKNAME Date of Birth

Place of Birth

Nationality

Sex

Civil Status

Religion

Permanent Home Address

Zip Code

Address in Metro Manila (if different from Permanent Home Address)

Zip Code

Home phone no. Father’s Name No. of older siblings

Mobile no. Father’s Occupation

Email address Mother’s Name

Mother’s Occupation

If married

No. of younger siblings

Name of Spouse

No. of children/dependents

Date of marriage

For applicants who are currently working Nature of work

Work Address

Position

Name of employer/business

Work phone no.

In the box below, state and describe briefly any illnesses or health concerns

EDUCATION AND QUALIFICATIONS

Name of School

Years Attended

Degree or Equivalent

High School

College

Graduate School

Others

Government/Licensing Exam(s) Passed

Professional certifications

Membership in Professional Organizations, Associations, etc.

General Weighted Average (GWA) obtained in undergraduate course

SCHOLASTIC INFORMATION List and explain all your academic achievements, honors, awards received in college/university, and extra-curricular activities. Indicate when you received them.

Were you ever dismissed/suspended/meted any form of disciplinary action (academics or conduct) in any of the schools you attended? ___ Yes ___ No. If yes, please explain.

Employer and Address

WORK HISTORY Position

Employment Period (From To)

1.

How did you learn about the UA&P’s MPE program? _____ UA&P website _____ Tarpaulin, posters, brochures and displays _____ Facebook, Twitter, Social Media _____ Family or friends. If so, how did they know ________________ _____ Newspaper Advertisement ___________________________________________________

2.

What are your career objectives? How would the MPE program help you achieve these objectives?

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__________________________________________________________________________ ________________________________________________________________________________________________________ CERTIFICATION I hereby certify that I have read and fully understood all the instructions regarding my application for admission to the MPE program of UA&P, and that the information stated in this application form and its attachments are correct and complete. I understand that incomplete or inaccurate information could be prejudicial to my application. If accepted as a student of UA&P, I agree to abide by all its policies and regulations.

APPLICANT’S SIGNATURE __________________________________________________ DATE _____________________