UNIVERSITY OF THE PHILIPPINES DILIMAN
Office of the Vice-Chancellor for Academic Affairs
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Rm. 102, DILC Bldg., Magsaysay Ave. cor. Apacible St. UP Diliman, QC
INTERNATIONAL STUDENT EXCHANGE PROGRAM
APPLICATION FORM
PLEASE WRITE IN BLOCK LETTERS AND AS LEGIBLY AS POSSIBLE.
PERSONAL INFORMATION
NAMEa: _______________________________________________________________________________
NATIONALITY: _________________ DATE OF BIRTHb: ___ / ___ / ___ AGE (as of 2/29/16): _____
PASSPORT NO.: ________________ DATE ISSUEDb: ___ / ___ / ___ VALID UNTILb ___ / ___ / ___
PRIMARY EMAIL: __________________________________ MOBILE NO.: _______________________
PRESENT ADDRESS: ____________________________________________________________________
PERMANENT ADDRESS: ________________________________________________________________
ACADEMIC INFORMATION
STUDENT NO.: _______________________ YR. LEVEL: _______ CUMULATIVE GWA: __________
COLLEGE: ______________________ DEGREE PROGRAM: ________________________________
LANGUAGE PROFICIENCY/COURSES TAKEN: ____________________________________________
_________________________________
INSTITUTION: _____________________________________
PARTNER UNIVERSITY APPLIED FOR
1ST CHOICE: ___________________________________________________________________________
2ND CHOICE: __________________________________________________________________________
3RD CHOICE: ___________________________________________________________________________
PERSON TO NOTIFY IN CASE OF EMERGENCY
PARENT / LEGAL GUARIAN: ____________________________________________________________
RELATIONSHIP WITH STUDENT: ________________________________________________________
ADDRESS: ____________________________________________________________________________
CONTACT NO.: __________________________________ EMAIL: _________________________
CHECKLIST OF ATTACHMENTS (3 COPIES, A4-SIZE PAPER)
If applying for the Bilateral Student Exchange Programs
(Korea, Japan, Taiwan, Austria, France, Germany, Sweden)
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aas
UPD ISEP Application Form
Curriculum Vitae
Latest TCG w/ CGWA computation
2 recommendation letters from UP Professors
Study Plan / Essay (500-750 words)
Photocopy of Form 5 (1st Sem AY 2014-2015)
Photocopy of valid passport
Conforme signed by parent / legal guardian
shown in passport
bmm/dd/yy
If applying for the TF LEaRN Program (Singapore)
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UPD ISEP Application Form
Curriculum Vitae
Latest TCG with CGWA computation
Certification from College Sec that student is among top
5/10% of his/her academic cohort
2 recommendation letters from UP Professors
(1 highlighting leadership and community service)
Study Plan / Essay (500-750 words)
Photocopy of Form 5 (1st Sem AY 2014-2015)
Photocopy of valid passport
Conforme signed by parent / legal guardian