FORM NGSE-01
National Graduate School of Engineering
Staple two pieces of
passport-sized
photographs here
College of Engineering
UNIVERSITY OF THE PHILIPPINES
Diliman, Quezon City 1101 Philippines
APPLICATION FORM
ADMISSION TO THE GRADUATE PROGRAM
GALINGAN
ROMALYN
LAST NAME
GIVEN NAME
LAMBENGCO
MIDDLE / MAIDEN NAME
INSTRUCTIONS
1.
2.
3.
4.
Accomplish properly Form NGSE-01.
Pay a non-refundable application fee of PHP 100.00 for Filipino and resident foreign applicants at the Cashier's Office. For non-resident
applicants, send a check of USD 20.00 payable to the University of the Philippines together with the application documents.
Request three (3) former professors or technical experts acting as your supervisor as references to accomplish Form NGSE-02. Each
accomplished form should be enclosed in a sealed envelope, with a signature across the seal. Accomplished forms may be returned to
the applicant or may be sent directly to the NGSE Office.
Submit all the accomplished forms together with the following requirements:
One (1) official copy and two (2) photocopies of Transcript of Records bearing the school seal and the registrar's signature
Application fee receipt
Three (3) recent passport size pictures
Original and one (1) photocopy of NSO Birth Certificate (for Filipino applicants)
Photocopy of passport (for foreign applicants)
TOEFL official score (Only for foreign applicants whose native language or primary medium of instruction in secondary school
and college is not English). A score of at least 61 in the internet-based Test of English as a Foreign Language (Education Testing
Service, Princeton, New Jersey, 08540 USA) is required.
5.
Wait for the final decision on your application, which will be communicated to you by email and/or phone.
For National Graduate School of Engineering Office Use Only
(To the applicant: Do not fill this portion)
Date of Submission
O.R. Number
Received by
SCHOOL
AVERAGE
BS
MS
For Department/Institute/Program Admission Committee Use Only
(To the applicant: Do not fill this portion)
The Department/Institute/Program Admission Committee recommends that the applicant be
admitted as a graduate degree student
admitted as a non-degree student (probationary admission) subject to the following condition(s):
refused admission
Department Chairman / Institute Director / Program Coordinator
Printed Name & Signature
Date
FORM NGSE-01
I.
PROGRAM OF STUDY
1.a. Degree Program. Choose only one degree and one graduate program.
X Master of Science
CE
ChE
Doctor of Philosophy
CE
Master of Engineering
EE
Doctor of Engineering
ChE
CS
ChE
EE
EEE
EgyE
EnE
EnE
EgyE
GmE
IE
ME
MetE
MSE
MSE
IE
EEE
EgyE
1.b.
X THESIS OPTION
NON-THESIS OPTION (For MS CE-G, MS CE-S, MS CE-W, MS ChE, MS MSE only)
1.c.
X Full-Time
Part-Time
1.d. For THESIS OPTION: Choice of Research Field. Answer only for the degree program you have chosen above.
Rank your first 3 choices by writing numbers 1 to 3 in the boxes (1 being the highest priority)
CIVIL ENGINEERING (CE)
Geotechnical
Structural
Transportation
Water Resources
CHEMICAL ENGINEERING (ChE)
Biological
Environmental
Fuel Energy &
Materials &
Process Systems
Engineering
Engineering
Thermal Systems
Catalysts
Engineering
COMPUTER SCIENCE (CS)
Algorithms & Complexity
Scientific Computing
Computer Security
Computer Vision &
Network &
Machine Intelligence
Distributed Systems
Software Engineering & Service Sciences
Web Science
Computers &
Instrumentation
Microelectronics
Power Systems
Communications
& Control
ELECTRICAL ENGINEERING (EE)
ENERGY ENGINEERING (EgyE)
Renewable Energy
Energy Storage
Biofuels
Resource Assessment
Energy Planning
Energy Modeling
Waste-to-Energy
Others:
ENVIRONMENTAL ENGINEERING (EnE)
Air Quality Management
Environmental Management
Solid & Hazardous Waste Management
Geoenvironmental Engineering
Water Quality Management
GEOMATICS ENGINEERING (GmE)
Applied Geodesy
Geoinformatics
Remote Sensing & Photogrammetry
INDUSTRIAL ENGINEERING (IE)
X Production Systems
Human Factors & Ergonomics
Operations Research
Information Systems
MATERIALS SCIENCE & ENGINEERING (MSE) - Joint Program with the UP College of Science
Metals and Alloys
Ceramic Materials
Polymeric Materials
Composite Materials
Semiconductor Materials
Biomaterials
Nanomaterials
Materials for Energy
Green & Environmental
High-Value Adding
Materials Forensics
Materials
of Local Materials
(e.g. Corrosion Engineering and Failure Analysis)
MECHANICAL ENGINEERING (ME)
Automation, Control & Robotics
Biomechanics
Heating, Ventilation, Air Conditioning & Refrigeration
Computational Mechanics
Machine Design
Fluids Engineering
Power
Vehicle Engineering
METALLURGICAL ENGINEERING (MetE)
Minerals Processing
1.e. Intended start of program study
1.f.
Metal Extraction
First Semester
Physical Metallurgy
X Second Semester
Ultrafine Processing
AY
2016
2017
Are you applying for another scholarship/grant?
Yes
X No
If yes, what is the name of the scholarship program which you are applying for?
1.g. For THESIS OPTION: Indicate the name of the potential research adviser (list provided in the brochure or the UP COE website)
ASSISTANT PROFESSOR NESTOR RAESES
FORM NGSE-01
II.
PERSONAL INFORMATION
2.a.
Last Name
GALINGAN
Given Name
ROMALYN
Birth Date (MM/DD/YY)
Middle Name
LAMBENGCO
Birth Place
MARIKINA CITY
Civil Status
MARRIED
Citizenship
FILIPINO
Kindly write in BLOCK LETTERS
Maiden Name for married female applicants
2.b.
Male
Female
JUNE
Country of Origin
PHILIPPINES
Current Address
15 TINDALO ST. OCTAGON SUBDIVISION, BRGY DELAPAZ PASIG CITY
18
1988
No P.O. Box
Postal Code
Permanent Address
2.d.
2.e.
Country
1160
Telephone Number
09395166039
Fax Number
n/a
E-mail Address
[email protected]
Fathers Name
MARCELINO LAMBENGCO
Mothers Name
EMILY LOMIO
PHILIPPINES
Write the Maiden NAME.
Emergency Contact Person
Complete Name
SONIA Z. GALINGAN
Complete Address
15 TINDALO ST. OCTAGON SUBDIVISION, BRGY DELAPAZ PASIG CITY
Relationship
MOTHER IN LAW
Contact Number
09294705081
III.
EMPLOYMENT INFORMATION
3.a.
Current Employment Status
3.b.
Currently Employed Applicants (Full-Time/Part-Time)
3.c.
PHILIPPINES
15 TINDALO ST. OCTAGON SUBDIVISION, BRGY DELAPAZ PASIG CITY
Postal Code
2.c.
Country
1160
Self-Employed
Employed Full-Time
Employed Part-Time X
Position
Length of Service
Company Name
Telephone Number
Office Address
Fax Number
E-mail Address
Company Website
Unemployed
Self-Employed Applicants
Business Name
Business Address
3.d.
E-mail/Website
Telephone Number
Type of Business
Years of Operation
Employment History
Period (MM/YYYY)
From
To
Full-Time (F) or
Part-Time (P)
02/2009
08/2012
Name of Employer
APAC CUSTOMER SERVICES
Title/Position
CLAIMS SPECIALIST
FORM NGSE-01
IV.
ACADEMIC BACKGROUND
4.a.
SECONDARY EDUCATIONa
Last High School Attended
4.b.
4.c.
School Name
FE DEL MUNDO NATIONAL HIGH SCHOOL
School Address
MANSALAY, B. DEL MUNDO ORIENTAL MINDORO
Date Started
0 6
/ 2 0 0 0
Date Graduated
0 4
/ 2 0 0 5
TERTIARY EDUCATIONa,e
Name of Institution
Location
Degree Received
TECHNOLOGICAL INSTITUTE
OF THE PHILIPPINES
QUEZON CITY
BSIE
Location
Degree Received
Enrollment (MM/YYYY)
From
Until
06/2011
04/2016
POST-GRADUATE STUDIESa,b,e
Name of Institution
Enrollment (MM/YYYY)
From
Until
n/a
4.d.
4.e.
SCHOLASTIC HONORS & AWARDS RECEIVEDe
Title
Awarding Institution
Date Received
MAGNA CUM LAUDE
TIP QC
04/2016
Title of Publication
Date Published
AHFE 2015 Proceedings (Volume 3). Pages 16614 (2015). The 6th International Conference on
Applied Human Factors and Ergonomics (AHFE
2015) and the Affiliated Conferences.
10/27/15
RECENT SCIENTIFIC PUBLICATIONSc,e
Title of Paper
Human Error Reduction for Process improvement
in a Processing Company (2015)
http://www.sciencedirect.com/science/journal/235
19789/3
4.f.
Taxonomization Model Development of a
Processing Company: A DEA-Based Approach
(2015)
Waiting
Linear Programming-Based Minimization of the
Purchasing Costs in Company X (2016)
Waiting
RECENT SCIENTIFIC CONFERENCE PRESENTATIONSc,e
Title of Paper
Linear Programming-Based Minimization of the
Purchasing Costs in Company X (2016)
Taxonomization Model Development of a
Processing Company: A DEA-Based Approach
(2015)
Human Error Reduction for Process
improvement in a Processing Company (2015)
Six Sigma DMAIC Problem: Critical-to-Quality
Characteristic Improvement of a Processing
Company (2014)
4.g.
Name of Conference
Date Presented
INTERNATIONAL BUSINESS
ENGINEERING CONFERENCE (Kuala
Lumpur Malaysia)
ASIA PACIFIC INDUSTRIAL
ENGINEERING AND MANAGEMENT
SYSTEMS CONFERENCE (Ho Chi Minh,
Vietnam)
APPLIED HUMAN FACTORS AND
ERGONOMICS CONFERENCE (Las
Vegas, USA)
ORSP NATIONAL CONFERENCE
(Manila, Philippines)
OTHER QUALIFICATIONSd,e
Civil Service Commission Honor Graduate Eligibility (Certificate number 100113160758)
a
Verified copies of academic documents must be attached to this application. Filipino or English translations are STRICTLY required.
All postgraduate studies taken, up to obtaining a masters degree.
c Done within the last FIVE YEARS.
d Membership to professional organizations, eligibilities/certificates, professional licenses, etc.
e Use a SEPARATE SHEET if necessary (e.g. title is too long, insufficient number of rows, etc.).
b
09/2016
12/2015
07/2015
11/2014
FORM NGSE-01
V.
ENGLISH PROFICIENCY
For foreign applicants only.
First Language
Primary Medium of Instruction
Secondary Level
Tertiary Level
Test of English Language Proficiency. Must attach TOEFL Official Score Certificate.
Date Taken
Exam Score
VI.
PROGRAMMING PROFICIENCY
Required for MS & PhD CS applicants; optional/additional qualification for the others.
List the programming languages (e.g. C, C++, Java) you are proficient in & the projects/applications completed using these languages.
Level of Proficiency
(1 lowest, 5 highest)
Programming Language
Level of Proficiency
(1 lowest, 5 highest)
Programming Language
Projects/Application
Title/Name of Projects/Application
VII.
Programming Language(s) Used
ADMISSION ESSAY
Write an essay on a separate sheet of paper about the following:
For CS
Discuss in at least 300 to a maximum of 500 words about yourself, your qualifications relevant to your application
to the graduate program, and your future plans with respect to your chosen plan of study.
For EE
Discuss details of your other qualifications (e.g. membership in professional bodies, certificates, scholastic honors
received) that are relevant to your application to the graduate program, past or ongoing research & development
work/experience, research areas of interest, and reasons for applying for the graduate program. You may also
indicate professors and/or research laboratories in the department whose work you are interested in joining. If you
plan to be a part-time student, discuss the relationship of your planned graduate studies to your present
employment and the support, if any, of your present employer for your planned graduate studies.
For EgyE
For MS: In at least 200 words, discuss why you would like to take MS EgyE.
For PhD: In at least 400 words, discuss why you would like to take PhD EgyE and what area of interest you would
like to pursue.
For EnE
For MS: In at least 200 words, discuss why you would like to take MS EnE.
For PhD: In at least 400 words, discuss why you would like to take PhD EnE and what area of interest you would
like to pursue.
FORM NGSE-01
VIII. REFERENCES
IX.
Name
Company of Affiliation & Address
Telephone Number
ENGR. ARIANNE A. PALISOC
TIP QC
09065323189
ENGR. JAYPY T. TENERIFE
TIP QC
09175198845
ENGR. GERALD SEMIFRANIA
TIP QC
DR> ROSALINDA P. VALDEPEAS
TIP QC
09175781285
APPLICANTS DECLARATION
I declare that the information supplied in this application and the documentation supporting it are true
and complete. I acknowledge that the provision of incorrect information or documentation relating to
my application may result in cancellation of admission or enrolment. If admitted to the National
Graduate School of Engineering, I solemnly agree to abide by the rules and regulations of the College of
Engineering and the University of the Philippines.
ROMALYN L. GALINGAN
NOVEMBER 14, 2016
Signature Over Printed Name
Date
For any inquiries, please contact the National Graduate School of Engineering Office:
NGSE Office, College of Engineering
Rm. 119 Melchor Hall, Osmea Avenue
University of the Philippines Diliman
Quezon City 1101 PHILIPPINES
Telephone +632-981-8500 local 3105/ 3106
Fax +632-926-0723
E-mail [email protected]
FORM NGSE-02
National Graduate School of Engineering
College of Engineering
UNIVERSITY OF THE PHILIPPINES
Diliman, Quezon City 1101 Philippines
LETTER OF RECOMMENDATION
NATIONAL GRADUATE SCHOOL OF ENGINEERING (NGSE) ADMISSION
APPLICANTS INFORMATION
Last Name
GALINGAN
Given Name
ROMALYN
Middle Name
LAMBENGCO
Address
To be filled out by the applicant
Maiden Name for married female applicants
15 TINDALO ST. OCTAGON SUBDIVISION BRGY DELA PAZ PASIG CITY
Postal Code
Degree Applied For
1600
Country
PHILIPPINES
MASTER OF SCIENCE IN INDUSTRIAL ENGINEERING
Note to the Applicant: Ask the recommender to enclose this Form GPC-03 in a sealed envelope, with his/her signature written
across the seal. The envelope must be submitted with its seal unbroken together with the rest of your application materials to the
National Graduate School of Engineering Office, Rm. 119, College of Engineering, U.P. Diliman.
APPLICANTS EVALUATION
To be filled out by the recommender
Note to the Recommender: Any pertinent information regarding the applicant and your evaluation of the applicants ability to
undertake graduate studies and research will be held in strict confidence.
How long have you known the applicant?
In what capacity have you known the applicant?
If the applicant was a student in some of your classes, what were these subjects?
What do you consider as the applicants outstanding talents or strengths in relation to graduate study?
FORM NGSE-02
What do you consider as his/her weakness or deficiencies in relation to graduate study?
Please rate the applicant on the following characteristics in comparison with other students in the same disciplines who are known to
you and who have had more or less the same amount of training and experience. Indicate size of the group with which applicant is
being compared and its educational level.
Group Size
Educational Level
Excellent
1.
Intellectual ability
2.
Academic preparation for proposed field of study
3.
Motivation for proposed field of study
4.
Originally, creativity & imagination
5.
Analytical & problem-solving ability
6.
Initiative and independence
7.
Honesty & integrity
8.
Conscientiousness & ability to work independently
9.
Ability to work with others
Above
Average
Average
Below
Average
No Basis
10. Oral communication skills
11. Written communication skills
12. Emotional maturity
13. Potential as a researcher in the discipline
14. Potential as a teacher in the discipline
Additional information and comments about the applicants (please use a separate sheet of paper, if necessary).
I therefore
strongly recommend
recommend
recommend with reservations
the applicant for admission to the National Graduate School of Engineering in UP Diliman.
Signature Over Printed Name
RECOMMENDERS INFORMATION
Title
Engr./Dr./Prof.
Given Name
Last Name
Affiliated Organization
Position in Organization
Address of Organization
Highest Educational Attainment
Middle Initial
do not recommend
Date
