Application Form

Admissions to the Associate in Arts (Theatre) Program

AY 2022-2023

INSTRUCTIONS. Please fill out this form. Do not leave anything blank.
Privacy Notice: In recognition of the constitutional and inherent right of people to privacy, the University of the PhilippinesDiliman
(“UP Diliman”) advances its commitment to protect and uphold the privacy of personal information through this UP Diliman Privacy
Policy for Applicant Students, Faculty, and Staff.

This Policy is a derivative of and subject to the UP Diliman Privacy Policy at https://upd.edu.ph/privacy/dilimanprivacy. Access
the full privacy notice HERE

I. PERSONAL DETAILS
Name
Sex Assigned at Birth Civil Status
Date of Birth Age
Citizenship Birthplace
Present Address
Permanent Address
Email Address Mobile No.

PERSON TO CONTACT IN CASE OF EMERGENCY

Name
Relationship to the Applicant
Present Address
Permanent Address
Primary Contact Number

II. ACADEMIC BACKGROUND

Senior High School / High School Attended

Name of School
School Address
Contact Details of School
Years Attended
Date of Graduation
Strand (if applicable)

College/s Attended
Name of School Years Attended Degree/s Pursued
III. PERSONAL STATEMENT. In 500 words or less, explain why you want to study
Theatre Arts. Why should we accept you to the program?
 CERTIFICATION
I hereby certify that the information given herein is true to the best of my knowledge. It is
understood that upon my admission to the College of Arts and Letters, I shall be governed
by existing rules and regulations of the College and of the University of the Philippines.

Signature over Printed Name Date

CONSENT FORM
I have read the University of the Philippines' Privacy Notice for Students. I grant my consent
to and recognize the authority of the University of the Philippines to process my personal and
sensitive personal information, pursuant to the abovementioned Privacy Notice and
applicable laws in connection with my application to shift/transfer/be admitted as a student of
UP Diliman.

I likewise consent to and recognize UP's authority to post online and/or in UP bulletin boards
at its option my name and program in the event I qualify for admission in order for the
University to comply with its Charter and uphold the principle of transparency in the
admissions process.

Signature over Printed Name Date

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