Expanded Tertiary Education Equivalency and Accreditation Program

Lyceum of the Philippines University-Batangas Inc.

Capitol Site, Batangas City 2 x 2 Photo

ETEEAP APPLICATION FORM

INSTRUCTION:
Please type or print clearly, provide complete and detailed information required. Do not leave
blank unanswered; write “Not Applicable” as the case may be. All declarations that you make herewith
are under oath. Discovery of any false claim in this application form will disqualify you from participating
in the program. Use additional sheets if necessary.

I. PERSONAL INFORMATION

1. NAME (Last Name, First Name, Middle Name)

______________________,___________________________,____________________
2. Address :
________________________________________________________________
Zip Code : _______________
3. Telephone No(s). : _____________________________
4. Birth Date : _________________________
5. Birthplace : _________________________
6. Civil Status : ________________________
7. Sex : ___________ Nationality : ____________________
8. Languages and Dialects Spoken : _________________________________
9. Degree Program or field being applied for :
First Priority : _______________________________________________
Second Priority : _______________________________________________
Third Priority : _______________________________________________
10. Statement of your goals/objectives/purposes in applying for the degree.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_________________________________
11. Indicate how much time you plan to devote for personal learning activities so that you can
finish the requirements in the prescribed program. Be specific.
_______________________________________________________________________
_______________________________________________________________________
______________________
12. For overseas applicants, describe how you plan to obtain accreditation/equivalency. (e.g.
when you plan to come to the Philippines)
_______________________________________________________________________
_______________________________________________________________________
_______________________________
13. How soon do you need to complete equivalency/accreditation?
_____ less than one (1) year _____ 1 year
_____ 2 years _____ 3 years

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 Expanded Tertiary Education Equivalency and Accreditation Program

II. EDUCATION:

This section will require you to provide information on your past formal, non-formal and
informal learning experiences.

1. Formal Education
Inclusive Dates of
Course/Degree Program Name of School/Address
Attendance

Note : All entries should be supported by authenticated photocopy of appropriate

certificates/documents obtained from the institution through the program.

2. Non-Formal Education
Non-formal education refers to structured and short-term training programs conducted for a
particular purpose such as skills development, values orientation, and the like.
Inclusive Dates of
Title of Training Program Title of Certificate Obtained
Attendance

Note : All entries should be supported by authenticated photocopy of appropriate

certificates/documents obtained from the institution through the program.

3. Other Certification Examinations

Please give detailed information on certification examinations taken for vocational and other
skills.
Title of Certification Name/Address of
Date Certified Rating
Examination Certifying Agency

Note : All entries should be supported by authenticated photocopy of appropriate

certificates/documents obtained from the institution through the program.

III. PAID WORK AND OTHER EXPERIENCES

1. Post/Designation
_____________________________________________
2. Inclusive Dates of Employment
From : __________________ to __________________
3. Name and Address of Company
__________________________________________________
__________________________________________________
4. Terms/Status of Employment
______________________________
5. Name and Designation of Immediate Supervisor
_______________________________________________
_______________________________________________
6. Reason(s) for moving on to the next job.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
________________________________________________
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 Expanded Tertiary Education Equivalency and Accreditation Program

7. Describe actual functions and responsibilities in position occupied:

_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
________________________________________________
8. In case of self-employment, name three (3) reference persons:
____________________________________________________________
____________________________________________________________
____________________________________________________________
Note : Use another sheet if necessary, following the above format.

IV. HONORS, AWARDS, AND CITATIONS RECEIVED

In this section, please describe all the awards you have received from schools,
community and civic organizations, as well as citations for work excellence, outstanding
accomplishments, community service, etc.

1. Academic Award
Name and Address of
Award Conferred Date Awarded
Conferring Organization

2. Community and Civic Organization Award/Citation

Name and Address of
Award Conferred Date Awarded
Conferring Organization

3. Work Related Award/Citation

Name and Address of
Award Conferred Date Awarded
Conferring Organization

V. CREATIVE WORKS AND SPECIAL ACCOMPLISHMENTS

In this section, enumerate the various creative works you have accomplished and other
special accomplishments. Examples of these are inventions, published and unpublished literary
fiction and non-fiction writings, musical work, products of visual performing arts, exceptional
accomplishments in sports, social, cultural and leisure activities, etc. which can lead one to
conclude the level of expertise you have obtained on certain fields of interest. Include also
participation in competitions and prizes obtained.

1. Description :
_______________________________________________________________________
____
_______________________________________________________________________
_______________________________________________________________________
________________________________

2. Date Accomplished : ________________________

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 Expanded Tertiary Education Equivalency and Accreditation Program

3. Name and Address of Publishing Agency (if written, published work), or an

Association/Institution which can attest to the quality of the work.
_____________________________________________________
_____________________________________________________
Note : Use additional sheet if necessary, following the same format.

VI. LIFELONG LEARNING EXPERIENCE

In this section, please indicate the various life experiences from which you must have
derived some learning experience. Please include here unpaid volunteer work.

1. Hobbies/Leisure Activities
Leisure activities which involve rating of skills for competition and other purposes (e.g.
“belt concept in Tae-kwon-do) may also indicate your level for ease in evaluation. On the
other hand, watching Negosiyete on a regular basis can be considered a learning
opportunity.
_______________________________________________________________________
_______________________________________________________________________
________________________________

2. Special Skills
Note down those special skills you think must be related to the field of study you want
to pursue.
_______________________________________________________________________
_______________________________________________________________________
________________________________

Work-Related Activities
Some work-related activities are occasions for you to learn something new. For
example, being assigned to projects beyond your usual job description where you learned
new skills and knowledge. Please do not include formal training programs you already
cited. However, you may include here experiences that can be classified as on-the-job
training or apprenticeship.
_______________________________________________________________________
_______________________________________________________________________
________________________________

Volunteer Activities
List only volunteer activities that demonstrate learning opportunities, and are related to
the course you are applying for credit. (e.g. counseling programs, sports coaching, project
organizing or coordination, organizational leadership, and the like)
_______________________________________________________________________
_______________________________________________________________________
________________________________

Travels : Cite places visited and purpose of travel

Include a write-up of the nature of travel undertaken, whether for leisure, employment,
business or other purposes. State in clear terms what new learning experience was
obtained from these travels and how it helped you become a better person.

VII. To sum up please write an essay on how your attaining a degree contribute to your personal
development, your community, your workplace, society, and country.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
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 Expanded Tertiary Education Equivalency and Accreditation Program

__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________

I declare under oath that, the foregoing claims and information I have disclosed are true and
correct. Done in ________________________________, on this ______ day of
________________________.

Signed :

____________________________________________
Printed Name and Signature of Applicant

Community Tax Certificate ________________________

Issued on _____________________________ at ____________________________

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 Expanded Tertiary Education Equivalency and Accreditation Program

What is the ETEEAP?

Qualifications of a Candidate the HEIs shall authenticate the
documents before these are accepted as
The basic qualifications of the candidate are valid certification of a candidate’s
the minimum criteria for an applicant to qualify proficiency.
for admission to the program. The deputized The certificate of proficiency in some
HEIs have the prerogative to add on to these fields can be obtained from the Technical
their own admission criteria. Education and Skills Development
Authority (TESDA). The Professional
1. The candidate must be a Filipino citizen. Regulation Commission also gives
2. The candidate must possess a high licensure examinations for certain
school diploma or the PEPT placement technician occupations. Presentation of
equivalent to first year college. authentic certificates from any of these
The candidate must have graduated from two bodies shall be considered a
high school or obtained a PEPT straightforward compliance of this
placement at first year college. This requirement.
ensures that competencies for basic skills 6. Ability of the candidate to submit an
and functional knowledge must have been accomplished ETEEAP Application Form.
obtained in preparation for tertiary level The ETEEAP Application Form is a
education. package of information intended to assist
3. The candidate must have been employed the HEI faculty and staff to determine
for an aggregate of five (5) years in whether the applicant is eligible or not for
industry related to the academic degree the program.
program or discipline he is vying for.
The candidate must demonstrate
substantial experience in the field related
to the degree program. He must have The Expanded Tertiary Education
experiences in decision-making and Equivalency and Accreditation Program
planning, some supervisory (ETEEAP) is an educational assessment
responsibilities, and opportunity to scheme that recognizes knowledge, skills,
function within an organization. and prior learning obtained by individuals
4. The candidate must be at least 25 years from non-formal and informal education
old. He/She must present a birth experiences. By establishing equivalency
certificate to support the claim. competence standards and a comprehensive
The candidate must be mature and assessment system employing written test,
responsible in order to succeed in the interview, skills demonstration and other
rigorous process of assessment. He/She creative assessment methodologies, higher
must be able to cope with the discipline education institutions may administer
required in the alternative learning competency-based evaluation. A Panel of
program should he/she opt to avail of the Assessors is convened to determine the
competency enhancement scheme. candidate’s knowledge, skills and attitudes
5. The candidate must be proficient in a relevant to a particular discipline, and the
branch of the discipline applied for. To administering higher education institution
validate this, he must submit any of the awards appropriate equivalency credit or
following evidences: 1) certificate of academic degree to successful candidate
proficiency issued by the government
regulatory body, 2) certificate of The mandate to implement the Program is
proficiency issued by the employer(s), 3) embodied in Executive Order 330 issued by
certificate of proficiency issued by a President Fidel V. Ramos on May 10, 1996 as
licensed practitioner in the field (where an offshoot of the recommendation of the First
applicable), or 4) a business registration Employment Summit in September 1995.
certificate.
The candidate must show a certification
that he has achieved a certain level of
competence in the discipline for which
he/she aspires a degree. Furthermore,
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 Expanded Tertiary Education Equivalency and Accreditation Program

ETEEAP REQUIREMENTS
CHECKLIST OF DOCUMENTS REQUIRED FOR APPLICANTS
**Original documents must be submitted in CLEAR BOOK and Photocopy in Long Folder and
Brown Envelope.

PART I. Personal Information

• Letter of Introduction address to the ETEEAP Director (contains the intention of applying, a brief
description of self, interests & work experiences)
• Comprehensive Resume w/ Job description
• Accomplished ETEEAP Application Form with 1 x 1 picture
• PSA Birth Certificate / Affidavit of Birth
• PSA Marriage Certificate (for married female applicants)
• HS Card / FORM 137 / Transcript of Records
• Good Moral Certification
• Updated NBI Clearance or Barangay Clearance
• Letter of Recommendation from Immediate Superior

PART II. Work Summary

• Certification of Employment (most recent to the most remote including Job description)

PART III. Professional Achievements / Development

• Proficiency Certificate (PRC, TESDA, Licensed Practitioner in the field, Business registration or any
Government Regulatory Board)
• Document of Merits (Honors, Awards, Citation)
• Certificate of Professional Development (Training, Seminars, Workshops, Travels,
Short Term Courses)
• Creative Works and Special Accomplishment (Inventions, Innovations, Publications)
• Membership in Professional Organization (Government, Private, Civic Organization)

Note: Please provide ONE set of photocopied documents to be submitted together with the original.

LYCEUM OF THE PHILIPPINES UNIVERSITY- BATANGAS, Inc

ETEEAP OFFICE

Telephone Nos.: (043) 723-0706 loc 120 /181

Mobile Phones: Globe +639156636204
Smart +639218183113

Email Address: [email protected]

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