OUR LADY OF FATIMA UNIVERSITY

Valenzuela City

120 McArthur Highway

Tel (+632) 291-6644 * 2916538 loc 110
* 291-6504

Quezon City

Hilltop Subd., Lagro

(+632) 935-2947 * 419-5363

Most recent photo

2 identical copies 2 x 2

Antipolo City

Km 25, Sumulong Highway,

Sta. Cruz
(+632)571-8993 * 661-3023

GRANTED AUTONOMOUS STATUS - March 2009

www.fatima.edu.ph

ACCREDITATION: PACUCOA, ASCU-AII, TESDA, PASMETH, SEEADE

ISO 9001 - 2008 CERTIFIED

COLLEGE OF MARITIME EDUCATION - ISO 9001:2008 CERTIFIED

APPLICATION FOR ADMISSION

Freshman

Instruction:
1. Student-applicant accomplishes this Application Form properly.
2. Type or print all information. Print None or N.A. (not applicable) where necessary.
3. Submit requirements of the course as scheduled.

Transferee

Degree Holder

Course Applied for: ___________

Applicants
Last Name: ________________________ First Name: ________________________ Middle Name: ________________________

Male

Female

Date of Birth:
Place of Birth:
MM_____ / DD_____ / YY_____ City or Province: ________________________ Civil Status: _____ Religion: _________ Citizenship: ________________
Present Address:
Barangay / Village
House No. & Street: ___________________________________________ Town / City / Province: ______________________________ Zip Code: _______
Landline: ___________________________ Mobile: _______________________________ E-mail Address: ______________________________________
Fathers
Home
Name: _____________________________________ Address: _____________________________________
Business
Occupation: _________________________________ Address: _____________________________________

Landline: ___________________________
Mobile: ___________________________
Landline: ___________________________
Mobile: ___________________________

Mothers
Home
Name: _____________________________________ Address: _____________________________________
Business
Occupation: _________________________________ Address: _____________________________________

Landline: ___________________________
Mobile: ___________________________
Landline: ___________________________
Mobile: ___________________________

Guardian or Contact Person

Landline: ___________________________
In case of emergency: __________________________________ Relationship: _________________________ Mobile: ___________________________
Home or Oce Address: _____________________________________ Landline: _______________________ Mobile: ___________________________
SIBLINGS (Brothers & Sisters)
Name

Age

School Address or Profession / Occupation & Address

For additional listing, please use the other side of this sheet.

EDUCATIONAL ATTAINMENT
Elementary
School:________________________________________
High School
School:________________________________________

Address
Year Graduated
City / Town / Province:____________________________________________ _____________
Address
City / Town / Province:____________________________________________ _____________

If Transferree, previous college or

tertiary school attended before this application: ___________________________________________________

Address: City / Town / Province:

_____________________________

Course: __________ Years Enrolled: From ________ to ________ Reason of Leaving: ________________________________________________________

I hereby certify that I have accomplished this Application Form truthfully and to the best of my knowledge and that, if
admitted, I shall abide by all the School Regulations and Policies promulgated by the Our Lady of Fatima University. I also
understand that Our Lady of Fatima University does not approve of any fraternity and sorority; therefore, no initiation will be
performed inside and outside of the school premises.
Signature of Student ________________________ Date ___________________
Processing Fees: Non-Refundable:
AF: OR No. _________________ P _______________
MF: OR No. _________________ P _______________

Date _________________
Date _________________

Place a check before the desired Payment Plan.

Full
Plan A -- 3 Payments
Plan B -- 4 Payments

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - For Admissions Oce Use - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Remarks:

_________________________________________________________________ Admissions Ocer ____________________
_________________________________________________________________
Date ____________________