By accomplishing this Registration Form, the registrant hereby consents to collecting, processing, and storing of personal data by the

Bureau of Education Assessment

Disclosure:
for the exclusive purpose of facilitating his/her application for the Philippine Educational Placement Test (PEPT).

1. Download and complete this form

2. Email the accomplished form to pept.bea@deped.gov.ph
and wait for the payment details.
Republic of the Philippines
Department of Education
BUREAU OF EDUCATION ASSESSMENT

PHILIPPINE EDUCATIONAL PLACEMENT TEST

REGISTRATION FORM
Name of
Last Name First Name MI
Registrant
(Pangalan ng
Mag-eexam)

Mailing Person With Disability (PWD)

Address

Email Address (required) Date of Birth (MONTH/DD/YYYY | June/11/2007) Age Sex Contact Number

LRN (if available) Date of Registration (MONTH/DD/YYYY | June/13/2022) Last Grade Level Completed Level you are registering for

Reason for Applying Is the registrant currently enrolled?

Name of School Last Attended

Address of School Last Attended

Examination Center/ Division Division Code

DEPED CENTRAL OFFICE - BEA BEA-EAD
I hereby declare under oath that I have personally accomplished this Registration Form and that by affixing my name below, I am certifying that all documents attached to this application
are a faithful reproduction of the original, and that all statements and information provided therein are complete, accurate, and correct to the best of my knowledge. I am assuming full
responsibility and accountability for the correctness of the details provided and document's authenticity. I am aware that any violation will automatically disqualify me and authorize the
Bureau of Education Assessment (BEA) to deny the transaction I applied for and forfeit payments rendered.

Signature over Printed Name of Registrant

INSTRUCTIONS TO THE PEPT REGISTRANT AUTHORIZATION:

I hereby authorize the person whose name is indicated below

to transact and settle application and shipping payments on my behalf.

Signature over Printed Name of Authorized Representative

FOR THE EVALUATOR ONLY

(Do not answer this part)

Last Level Completed: Schedule of Exam:

Requirements: Purpose of Exam:
Birth Certificate (PSA/NSO/Local Civil Registrar) (Placement/Retake/Validation)
School Records (F137/SF10 with school seal &
signature of principal/registrar) Remarks:
Recent 1x1 Photo with name tag (colored)
PEPT Certificate of Rating (COR)
(for applicants who need to retake a PEPT subtest)
Endorsement Letter from the DepEd Level/s to take:
Regional and Division Offices
(for applicants who completed their last level from a private school
without a government permit to operate)

Proof of Payment
OR No. : Name & Signature of Evaluator / Date