1/21/2019 THANK YOU | REGISTRAR

            Your application is now on process.

FRESHMAN Your Code is: 5c4614b371fd1

(Please Print this FORM and present this to the Registrar's Clerk-in-Charge, ground floor of Edificio de
Sampaloc Building for confirmation of your application.)

REQUIREMENTS TO BRING:
1. Completely Filled Out A-Form
2. One(1) long brown envelope (with Surname,First Name,Middle Initial, written in capital letters at the
back-use pentel pen)
3. Photocopies of the following:
a.) Birth Certificate
b.) Barangay Certificate of Residency
c.) Parents latest ITR or Voter's I.D. or Voter's Affidavit
d.) Report Card - with 2nd quarter grades (for the 1st Batch)
            > certificate correct by the Guidance and/or Principal
            > with GW A of 83%
e.) Report Card - with complete grades(for 2nd-3rd Batch)
f.) Certification of Good Moral Character
g.) 4pcs. of 1 1/2X1 1/2 colored pictures with name tag(white background)
(Note: To Be Filled Out By the Office of the Registrar)
Name of Applicant: Landrito, John Alfred Basas
Your Application for UDM Admission Test is:
Approved
Please come back on the following schedule:
__________________   __________________   __________________
Date of Exam Time Room
Pending
____Due to lacking of requirements (Mark 'x' to any of the following):

1. Completely Filled Out A-Form

2. One(1) long brown envelope (with Surname,First Name,Middle Initial, written in capital letters at
the back-use pentel pen)
3. Photocopies of the following:
a.) Birth Certificate
b.) Barangay Certificate of Residency
c.) Parents latest ITR or Voter's I.D. or Voter's Affidavit
d.) Report Card - with 2nd quarter grades (for the 1st Batch)
            > certificate correct by the Guidance and/or Principal
            > with GW A of 83%
e.) Report Card - with complete grades(for 2nd-3rd Batch)
f.) Certification of Good Moral Character
g.) 4pcs. of 1 1/2X1 1/2 colored pictures with name tag(white background)

Please go to "HOME" tab for Course Offerings for your reference.

1st Choice: ______________________________
2nd Choice: ______________________________

http://udmregistrar.udm.edu.ph/saveadmitform.php 1/2
1/21/2019 THANK YOU | REGISTRAR

3rd Choice: ______________________________

_______________________________________
Assessed by Person-in-Charge

http://udmregistrar.udm.edu.ph/saveadmitform.php 2/2