PhiLSAT

Philippine Law School Admission Test

IDENTIFICATION (ID) FORM
(Must be SUBMITTED to the Watcher on the day of the test)

Application No.: 2041906030 MACANANG, ROSELLE MARA UNCIANO

Bank Reference No.:
2 X 2 ID Picture
3117493891 Name of Applicant (Name that will appear on your Answer Sheet and Certificate of Eligibility or Certificate of Grades)
1980-11-08 Female Philippines Married
Birthdate Sex Nationality Civil Status
Cagayan State University - Andrews, Tuguegarao City, Cagayan
Name of College/University Graduated From
Cagayan Philippines
Province/State of College/University Graduated From Country of College/University Graduated From
Bachelor of Elementary Education 1999-2000 With Master's degree units/subjects
College Course (Bachelor’s Degree) School Year Graduated Postgraduate Status

, BASAO, GATTARAN, CAGAYAN 3508 Philippines

Permanent Address

, BASAO, GATTARAN, CAGAYAN 3508 Philippines

Mailing Address
N/A +63-9068915488 rosellemarau@gmail.com
Landline No. Mobile No. Email Address
Test Location: Manila Supreme Court of the Philippines Government
Test Date: April 07, 2019 Name of Employer/Company Type of Employer/Company
Results to be: Sent via postal mail GATTARAN, CAGAYAN, Philippines Full-time
Address of Employer/Company Type of Employment
Test results and ID information released to
FOREIGN APPLICANT
requesting law schools? Yes
N/A N/A N/A
Law School Choices: Passport No. Expiry Date Place of Issue
1st: Cagayan State University PERSON WITH DISABILITY (PWD)
2nd: University of Cagayan Valley N/A N/A
PWD Card No. Type of Disability/Impairment
3rd: Saint Louis College
N/A
What special assistance/arrangement do you require on the day of the test?
MEDICAL CONDITION
None N/A
Do you have a medical condition? Describe the medical condition
N/A
What special assistance/arrangement do you require on the day of the test?
FOR THE PhiLSAT APPLICANT
1.  Affix your signature on the certification below.

I hereby certify that I have read and accepted all the information, terms and conditions specified on the PhiLSAT website www.philsat.com.ph, including,
among others, the PhiLSAT policies on allowed and prohibited items, on cheating or improper test-taking behaviour in any manner or form, and on failure to take
or complete the test on the test date and testing location indicated on this Form. I further certify that all information I gave on this Form is true and correct to the
best of my knowledge and that any misinformation shall constitute grounds for my disqualification from taking the PhiLSAT or invalidation of my PhiLSAT results.
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Applicant’s Signature Date Signed

2.  Bring this Form to the nearest Bank of the Philippine Islands (BPI) branch and pay the total of PhiLSAT Registration and Test Fees (PhP________)
PHP1000.00 on or
Downloaded on: Feb 15, 2019 10:00am

before _______________________.
March 01, 2019

Copy the Bank Reference No. found on the upper left portion of this Form and CEM’s BPI account number 1881-0450-24 on the BPI Payment/
Deposit Slip.
3.  Check your email (including your spam mailbox) after two (2) banking days for your payment confirmation e-mail. You must also visit the PhiLSAT website to
verify the status of your PhiLSAT application.
4.  Visit the PhiLSAT website two weeks before the test date to know your room assignment and to download your Examination Pass.
5.  Secure from the office of your College/University Registrar a Certificate of Graduation OR PhiLSAT Certification Form as proof that you GRADUATED from
the college/university with the college degree course and in the school year indicated on this Form.

Required Documents: On the day of the test, you must bring and submit to your Watcher this PhiLSAT ID Form
AND the CERTIFICATION signed by your College/University Registrar that you graduated from the school
indicated on this ID Form. Your PhiLSAT results shall be withheld indefinitely if you fail to submit any of these
two requirements.
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