Index No. F-QAA-2.

1-TSF

TECHNOLOGICAL UNIVERSITY OF THE PHILIPPINES Issue No. 01

Ayala Blvd., Ermita, Manila, 1000, Philippines
Tel No. +632-301-3001 local 709 | Fax No. +632-521-4063 Revision No. 00
Email: quality@tup.edu.ph | Website: www.tup.edu.ph
Date 09232019
Page 1/1
VPD-QAA TRACER STUDY FORM QAC No. CC-09232019

Please accomplish this form and attach a photocopy of your company ID or certificate of employment. Please check only the
most appropriate box whenever required.

Your Name: Company Name:

Date of Birth(mm/dd/yyyy): Year Started in the Company:
Sex:  Position / Designation:
Male  Female

Address: Monthly Salary Range: Job Status:

Contact No. (Mobile / Landline)  < 10,000
 10,000 – 15,000  Permanent
E-mail Address:
 15,000 – 20,000  Temporary
Year Graduated (please fill-up the year of your graduation)  20,000 – 25,000  Contractual/Project
 Bachelor: __________________________________________  25,000 – 30,000 Based
 Masteral: __________________________________________  30,000 – 35,000  Self-Employed
 Doctoral: __________________________________________  35,000 – 40,000
Degree Earned (please write the appropriate degree program):  > 40,000
 Bachelor: __________________________________________
 Masteral: __________________________________________
 Doctoral: __________________________________________
Professional Development: Programme: Type of Organization:
 Member of Professional Organization  Private
 BSME  BSEE
 PSME  IIEE  Government
 BSECE  BSCE
 IECEP  PICE  Non-Government
Organization (NGO)
 Others: ___________  Self-Employed
Continuous Professional Training: No. of Staff under your Industry:
 Trainings leadership  Research  Oil and Gas

 None 
 Education  Environmental
 Below 8 hrs ≥ 13
 1 to 3  Consultancy  Water
 8 – 24 hrs
 Manufacturing  Energy
 1 week – 2 weeks  4 to 7
 Government  Others
 3 weeks or more  8 to 12
Program Educational Objectives: (after 3-5 years of graduation, Name of Immediate Supervisor:
the graduates of the program are expected to)
 (PEO 1) Achieve a high level of technical expertise to succeed
Contact No: / Email of Your Company / Immediate
in their chosen profession Supervisor
 (PEO 2) Engage in lifelong learning activities such as
progressive leadership in applied research, development,
studies in technical, industrial and engineering fields and Is your current work aligned with your academic field of
production. specialization?  Agree (3)
 (PEO 3) Engage in professional services to effect technology  Strongly Agree (5)  Disagree (2)
transfer and assist in the development of small and medium
scale industries too contribute to national development.
 Moderately Agree (4)  Strongly disagree (1)
Date Filled Up: Your Signature Here:

Transaction ID
Signature