6/10/23, 10:26 PM LUAT Application - Laguna University

LU AA FO 97
LUAT Application Form

LAGUNA UNIVERSITY Application No. : LUAT-3135

Date of : June 26, 2023
Office of the Student Affairs and Services Examination
Laguna Sports Complex, Brgy. Bubukal, Santa Cruz, Time : 10:00-11:30
Laguna
Room : Computer Laboratory 3
Tel. Nos. (049) 501-4360
Date of Filing : April 13, 2023
Evaluated by :
APPLICATION FORM
Laguna University Admission Test (LUAT)

APPLICANT'S NAME:
Last:  First:  PAUL Middle:  MALDO
QUINTERO SEBASTIAN

LRN:  402704150202 CIVIL STATUS:  Single SEX:  Male CONTACT NO:  9184230373
EMAIL ADDRESS:  quintero.paul473@gmail.com CITIZENSHIP:  Filipino
PLACE OF BIRTH:  STA. CRUZ, LAGUNA DATE OF BIRTH:  2004-06-18
ADDRESS:  819 I. Mendiola St. ZIP CODE:  4019
LAST SCHOOL ATTENDED:
Siniloan Integrated National High School 2023 Academic
Excellence
Name of School  Year Graduated/Last SY Attended  Honors/Awards Received 
PROGRAM REFERENCE: 
First Choice:   Bachelor of Science in Computer Science Second Choice:   Bachelor of Science in Information Technology

FATHER'S NAME: “I hereby allow/authorize Laguna

University to collect, use and process the
Last:   QUINTERO First:   ENRICO Middle:   ELERIA information for legitimate purposes and
MOTHER'S NAME: allow authorized personnel to process the
information in accordance with the Data
Last:   QUINTERO First:   DORIS Middle:   MALDO Privacy Policies of the University.”
GUARDIAN'S NAME:
Last:   QUINTERO First:   Middle:   MALDO
PRANZYNE SYRELLE Applicant’s Signature over Printed
Name

LU Form no 3
LUAT Application Form
TEST PERMIT
Please bring this test permit, black pen & pencil on the scheduled date of your exam.
NO TEST PERMIT, NO EXAM.

Application No. : LUAT-3135

Date of : June 26, 2023
Examination
https://luat.lu.edu.ph/luat-application/LUAT-3135/Ipm30AevQX 1/2
6/10/23, 10:26 PM LUAT Application - Laguna University

Time : 10:00-11:30
Room : Computer Laboratory 3
Date of Filing : April 13, 2023
Evaluated by :
Name of Applicant : __________________________________________
Signature : __________________________________________

https://luat.lu.edu.ph/luat-application/LUAT-3135/Ipm30AevQX 2/2