UNIVERSITY OF THE PHILIPPINES VISAYAS

Graduate Program Office

Ground Floor, Graduate and Continuing Education Building
General Luna Street, 5000 Iloilo City, Philippines
Telefax. (63-33) 337-7982 e-mail: [email protected]











APPLICATION FOR ADMISSION



Date


Sir/ Madam:

I would like to apply for admission as a part-time/full-time student (encircle) in the
graduate program offered by UP Visayas (please check appropriate box).

Master of Management (MM)
(non-thesis program)
Ph.D. Fisheries
Business Management Master of Science in Fisheries (MSF)*
Public Management Aquaculture
Fisheries Biology
Diploma in Urban and Regional Planning
(DURP)
Fish Processing Technology

Master of Science in Ocean
Master of Education (MEd), Sciences (MSOS)*
(non-thesis program with Plans A & B)
Biology
English as a Second Language
Master of Marine Affairs (MMA)
(non-thesis program)
Filipino
Guidance Master of Aquaculture (MAq)
Mathematics (non-thesis program)
Physics
Reading Non-degree student
Social Studies
Special Student
Master of Chemistry (MChem)
(non-thesis program with Plans A &B)

Master of Science in Biology*


* with thesis program



Attach
2 x 2
picture





I am enclosing my application fee of Two Hundred Fifty Pesos (P250.00) only.
Also attached are the other requirements for admission:

a) Two (2) copies of accomplished application forms and information sheet
(three (3) copies for College of Fisheries and Ocean Sciences programs);
b) Two (2) letters of recommendation from former professors and/or immediate
supervisors in major area of study (use attached forms );
c) One (1) original and two (2) photocopies of undergraduate transcript of records
(with post-baccalaureate and graduate, if applicable);
d) Certificate of Honorable Dismissal/Certificate of Transfer Credential/Certificate
of Transfer Eligibility from the latest school attended;
e) One (1) original copy of birth certificate from the National Statistics Office;
f) One (1) original copy of marriage contract from the National Statistics Office
(for married female applicant only);
g) Official Test of English as a Foreign Language (TOEFL) results with minimum
score of 500 for foreign students from countries where English is not the
medium of instruction; and
h) Other requirements set by the College.

\

Truly yours,

_____________________________
Signature of Applicant

_____________________________
PRINTED NAME





Return Address:
___________________________
___________________________
___________________________
Email address:
___________________________
Tel. No.____________________
Fax No.____________________
Cell No. ___________________





Page 2 of 4

Information Sheet
(Please type or print legibly)
I. Personal Data

1. Name __________________________________________________________
First Middle Last
2. Date of Birth ____________________________________________________
3. Permanent Address ________________________________________________
4. Mailing Address___________________________________________________
5. Telephone No. ___________Fax No. ______________E-Mail ______________
6. Civil Status _______________________Sex_____________________________
7. Citizenship ________________________ No. of Dependents______________
8. For citizens of other country only. Please indicate means of support for the
duration of your stay in the Philippines.

Government Scholar Others, please specify
Self-supporting __________________________

II. Educational Attainment
Secondary Schools
Colleges & Graduate
Schools Attended
Inclusive Date
of Attendance

Highest Degree


Date Conferred







III. Academic Honors, Awards, Scholarships
Awards
Institution Conferring
Award
Date
Conferred





IV. Work Experience (start from the latest position). You may use additional sheet(s)
if necessary.
Position
Employer/
Institution
Date
From To
Brief Description
of Duties










Page 3 of 4

V. Professional and Civil Service Examination Taken
Title of Examination Date Taken Rating




VI. Professional Articles Published
Title of Publication and Where Published Date Published




VII. Professional and Community Organization
Organization
Nature of
Organization
Position Held
Inclusive
Dates




VIII. Statement of Thesis/Dissertation topic of interest (where applicable)
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

IX. List down below the names and addresses of your present employer and/or previous
employer or professors whom you have asked to fill out the Personal
Recommendation Form, to be mailed separately to the School. Please note that it is
your responsibility to check with the referee to assure prompt submission of the
recommendations.

Name_____________________________ Name______________________________
Position___________________________ Position____________________________
Address___________________________ Address____________________________
___________________________ ___________________________________

I hereby certify that the information given above are true to the best of my
knowledge. It is understood that upon my admission to the University of the Philippines in
the Visayas (UPV), I shall be governed by the rules and regulations of UPV and the
University of the Philippines System.




____________________ ______________________________
Date Signature of Applicant




page 4 of 4



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UNIVERSITY OF THE PHILIPPINES VISAYAS
Graduate Program Office
Ground Floor, Graduate and Continuing Education Building
General Luna Street, 5000 Iloilo City, Philippines
Telefax.: (63-33) 337-7982 E-mail: [email protected]


CONFIDENTIAL REFERENCE LETTER

Reference letters are to be placed in an envelope, endorsed across the back seal,
and returned to the applicant or mailed by the Referee to: The Director, Graduate
Program Office, University of the Philippines Visayas, General Luna Street, 5000
Iloilo City, Philippines. Applicants are not to open the envelope.

The person whose name appears below has applied for admission to the Graduate
Program. Your assessment of his/her personal qualification will be most helpful in
our consideration of his/her application. This recommendation will be considered
strictly confidential. If additional space is needed, please use additional sheets.


1. Name of Applicant ___________________________________________________
2. How long have you known the applicant? _________________________________
3. In what capacity have you known the applicant? ____________________________
___________________________________________________________________
4. Do you believe that the applicant is prepared for graduate work? _______________
___________________________________________________________________
5. What do you think are the strengths and weaknesses of the applicant? ___________
___________________________________________________________________
6. How would you rate him/her on the following scale?

Excellent Very
Good
Good Average Poor
Intellectual Ability
Diligence
Leadership
Administrative Ability
Cooperation
Dependability
Integrity
Ability to express himself orally
Ability to express himself in
writing


7. What other information could you provide about the applicant? ________________
__________________________________________________________________
__________________________________________________________________

Signature_____________________________ Position ___________________________
Name in Print_________________________ Organization________________________
Address______________________________ __________________________________
______________________________ __________________________________

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