rd

APPLICATION FOR ADMISSION

3 Floor , Times Plaza Building, United Nations Avenue corner Taft Avenue, Ermita, Manila
5th Floor, Walter Mart Mall, Chino Roces Avenue corner Arnaiz Avenue, Makati City
Tel Numbers: Manila (+632) 524-9996 • Makati (+632) 887-5329
Email: marketing@mihca.com.ph or makaticampus@mihca.com.ph

Important: 2x2
1. Provide all information needed. Write in bold letters PHOTO
2. Attach 2x2 current picture with white background
3. Submit this Form to the Admissions Office.

PREFERRED CAMPUS
BATCH NO.
PROGRAM APPLIED FOR
___________
Manila Makati
DATE OF BIRTH
SURNAME AGE
(mm/dd/yyyy)

GIVEN NAME PLACE OF BIRTH

MIDDLE NAME CITIZENSHIP

GENDER Male Female RELIGION

PROVINCIAL
HOME ADDRESS
ADDRESS

PHONE NUMBER
HOME NUMBER
(PROVINCE)

MOBILE NUMBER E-MAIL ADDRESS

EDUCATIONAL ATTAINMENT (Most Recent)

NAME OF INSTITUTION DATE INCLUSIVES DEGREE / DIPLOMA

1.

2.

EMPLOYMENT HISTORY

NAME OF COMPANY POSITION KIND OF WORK INCLUSIVE DATES

1.

2.
How will you finance your studies in MIHCA? Salary Savings Loan Parents / Relatives Others _____________________________

Why do you want to study in MIHCA?

How did you come to know about MIHCA? Website Career Orientation Job Fair Referral

Print Ad (please specify) ___________________ Others (pls. specify) ___________________

Do you have relatives working in If yes, please specify the name and department ___________________________
Magsaysay Maritime Corporation Yes No
(land-based office)? Relationship: _______________________________________________________

If yes, please specify the name and fleet _________________________________

Do you have relatives working on Yes No
board?
Relationship: _______________________________________________________

All information written in this application are true & correct to the best of my knowledge. I understand that any wrong information or misrepresentation, I may
be denied in admission and/or may be expelled from MIHCA.

____________________________________________ ______________________________
SIGNATURE OVER PRINTED NAME DATE

PAYMENT DETAILS

DATE O.R. NUMBER AMOUNT VERIFIED BY