TUP FORM 1-A (revised Aug 2017)

Technological University of the Philippines

OFFICE OF ADMISSIONS
Manila

APPLICATION FOR SCHOLASTIC AND TECHNICAL APTITUDE TEST

Applicant Number: 1819A0040

RIVERA FEDERICO JR. FORTUNATO

LAST NAME FIRST NAME MIDDLE NAME

HOME ADDRESS
223A Dalisay Batasan Hills Quezon City
No. Street Barangay/District Municipality/City

Direction: On the space provided, please write 1 if it is your 1st choice and 2 if it is your 2nd choice.

COLLEGE OF ARCHITECTURE AND FINE ARTS COLLEGE OF INDUSTRIAL TECHNOLOGY

Bachelor in Graphics Technology Bachelor of Engineering Technology
Mechanical Drafting Technology Electronics Technology option in Industrial
Industrial Design Engineering Maintenance
Architecture Technology Mechanical Technology option in Mechanical
Bachelor of Fine Arts Technology
Bachelor of Science in Architecture Mechanical Technology option in Foundry Technology
Mechanical Technology option in Welding Technology
COLLEGE OF INDUSTRIAL EDUCATION Mechanical Technology option in Automotive
Bachelor of Science in Industrial Education Technology
Computer Education Electronics Technology option in Industrial
Home Economics Automation Technology
Industrial Arts Mechanical Technology option in Heating Ventilating
Bachelor of Technical Teacher Education and Air-Conditioning/Refrigeration Technology
Bachelor of Technical Vocational Teachers Education Mechanical Technology option in Power Plant
Information and Communications Technology Technology
Electrical Mechanical Technology option in Dies and Moulds
Food Preparation Technology
Electronics Bachelor of Engineering Technology major in Computer
Automotive Engineering Technology
Cosmetology Bachelor of Engineering Technology major in
Construction Technology
COLLEGE OF ENGINEERING Bachelor of Engineering Technology major in Electrical
Technology
Bachelor of Science in Civil Engineering
Bachelor of Engineering Technology major in Electronic
Bachelor of Science in Electrical Engineering
Communications Technology
Bachelor of Science in Electronics Engineering
Bachelor of Engineering Technology major in
Bachelor of Science in Mechanical Engineering
Instrumentation and Control Technology
Bachelor of Engineering Technology major in Mechanical
COLLEGE OF SCIENCE
Technology
Bachelor of Applied Science in Laboratory Technology Bachelor of Engineering Technology major in
2 Bachelor of Science in Computer Science Mechatronics Technology
Bachelor of Science in Environmental Science Bachelor of Engineering Technology major in Railway
Bachelor of Science in Information System Technology
1 Bachelor of Science in Information Technology Bachelor of Science in Food Technology
Bachelor of Science in Hotel and Restaurant Management
COLLEGE OF LIBERAL ARTS Bachelor of Technology in Nutrition and Food Technology
Bachelor of Arts in Management major in Industrial Bachelor of Technology major in Apparel and Fashion
Management Technology
Bachelor of Science in Entrepreneurial Management Bachelor of Technology major in Print Media Technology
 PERSONAL DATA

Last Name RIVERA Sex Male Civil Status Single

First Name FEDERICO JR. Contact no. +63 912-9633-721
Middle FORTUNATO Extension Name(Jr., III): Jr. E-mail add / facebook account: Ricric Fortunato Rivera
Citizenship FILIPINO Place of Birth Caloocan City
Religion Roman Catholic Height 167.64 Weight 99.208
Permanent Address 223A Dalisay Batasan Hills Quezon City
Means of financial Support: Parents Scholarship Others

FAMILY BACKGROUND

Father's Name Federico Sr. Fernandez Rivera Mother's Name Jennifer Frogosa Rivera
Contact No. Contact No. +63 917-8485-468
Occupation Deceased Occupation Company Secretary

Name of Guardian Jennifer Frogosa Rivera

Complete Address
Contact No. +63 917-8485-468
Relationship Mother

EDUCATIONAL ATTAINMENT

School Last Attended (Secondary/Tertiary): Polytechnic University of the Philippines

School Quezon City
Exclusive Years/Attended 2017 Honor/Distinction
Grade 11/12 GWA: 86.56 MATH: 83.50 SCIENCE: 85.50 ENGLISH: 84.00
TRACK: General Academic

EMPLOYMENT BACKGROUND

Name of
Position: Inclusive Dates:

PLEDGE

I HEREBY AFFIRM THAT ALL THE ANSWERS GIVEN HERE ARE TRUE AND CORRECT. I UNDERSTAND THAT GIVING FALSE
INFORMATION WILL AUTOMATICALLY DISQUALIFY ME FOR ADMISSION OR SUBJECT TO DISMISSAL BY COMPETENT AUTHORITIES.
ADMITTED, I WILL ABIDE AND COMPLY WITH ALL THE POLICIES, RULES AND REGULATIONS OF THE TECHNOLOGICAL UNIVERSITY
OF THE PHILIPPINES

CERTIFIED CORRECT:

Signature of Student