Pnpa App Form 2009

Republic of the Philippines Department of the Interior and Local Government Philippine Public Safety College PHILIPPINE NATIONAL POLICE ACADEMY Camp General Mariano N Castañeda, Silang, Cavite 4129 Tel # (02) 396-4076/Tele Fax # (049) 545-5939)

PNPACAT Application Form Revised 2008

Recent Photo with name tag Original Copy (Passport Size) [1.5’ x 2”]

APPLICATION FOR PNPA CADET ADMISSION TEST

(IMPORTANT: READ INSTRUCTIONS AT THE BACK OF THIS FORM. ACCOMPLISH THIS FORM COMPLETELY & ACCURATELY) TEST CENTER PREFERENCE:__________________________________________________________________________ CODE: ___________

1. SURNAME

2.GENDER : Male Female

FIRST NAME MIDDLE NAME 3. COMPLETE MAILING ADDRESS with ZIP Code: 4. CIVIL STATUS: 8. AGE :

5. CITIZENSHIP:

BIRTHDATE :

Month Date

Year

REGION:______

Email Address:______________________ TEL NO.: (Res)_____________________ (Mobile)___________________________ 6. HEIGHT: (cm) 7. WEIGHT: (kg)

9. BIRTHPLACE:_______________________________________________ (City/Town/Province)

10. FATHER’S NAME: _____________________________ ADDRESS ______________________________________________ 11. MOTHER’S NAME: _____________________________ ADDRESS______________________________________________ 12. GUARDIAN’S NAME: ___________________________ Relationship ________________ ADDRESS___________________ 13. EDUCATION: (Please check highest educational achievement only)

High School Graduate: School: ________________________ _______________________________ Year Graduated: ____________________

College Undergraduate: Year 1st 2nd 3rd 4th 5th Level: [ ] [ ] [ ] [ ] [ ] Course: ________________________ School:

14. ELIGIBILITY(IES): TYPE OF EXAMINATION:

College Graduate: Degree: ________________________ School: ________________________

__________________________________ Year Graduated: DATE/PLACE OF EXAMINATION:

15. ARE YOU EMPLOYED: Yes No Office____________________________________________________________ Position __________________________ Address____________________________________________________________________________________________ Period of Employment _________________________ 16. Have you ever been dismissed from any employment, forced to resign or otherwise disciplined as a result of administrative case, or convicted of any violation of law, ordinance or regulations before any civil court and/or military tribunal? : YES NO If YES, attach copy of decision: 17. Do you have any criminal, administrative, or civil case on file before any Prosecutor’s Office or Court of Justice or other derogatory record(s)? YES NO YES NO 18. Do you have any parental obligation, or has sired a child or children? I hereby declare under the penalties of perjury that this application has been accomplished in good faith, verified by me and to the best of my knowledge and belief and is a true, correct and complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the Philippines. I also authorize the agency head or his/her representative to verify/validate the contents stated herein. _______________________________ (Signature of Applicant) SUBSCRIBED AND SWORN TO before me this _______ day of ________ at _______________________________ affiant exhibiting to me his/her community tax certificate number ________ issued on ______ at ___________________________________. _______________________________ Administering Officer DO NOT FILL THIS PORTION APPLICATION NO:_____________________________ QUALIFIED DISQUALIFIED REMARKS:____________________________________

Evaluated by: Signature Date

(REPRODUCTION OF THIS FORM IS ALLOWED) Application Form can be downloaded at www.pnpa.edu.ph or www.pinagod.com

INSTRUCTIONS Please read instructions carefully. Strictly comply with the qualification requirements. Inaccurate or incomplete information shall be a ground for disqualification. PLEASE SUBMIT ONE (1) APPLICATION ONLY. 1. Check if you have the following QUALIFICATIONS FOR ADMISSION: • • • • • • • •

A natural born Filipino citizen; Of good moral character; Male or female, single and with no legal obligation to support a child or children; 17 to 21 years old at the time of admission; Height of at least 162.5 cm (5ft 4 in) for male, and 157.5 cm (5ft 2 in) for female; Weight of not more nor less than five (5) kilograms of the standard weight measurement corresponding to height, age and sex; At least high school graduate; Must be able to perform the following physical fitness exercises: Exercises Pull-Ups Full Arms Hanging 2 min Push-Ups 2 min Sit-Ups 100 meter dash 1000 meter run

• • •

Male 10 40 55 17 sec 4:30

Female 40 sec 35 50 20 sec 5:30

Physically and mentally fit for cadetship; No criminal, administrative or civil case on file before any Prosecutor’s Office or any Court of Justice and other derogatory record(s); Not a former cadet of PNPA or other service academies.

2. Submit duly accomplished application together with a self-stamped WINDOW ENVELOPE to the Office of the Registrar or mail to: The Director, Philippine National Police Academy, Camp General Mariano N Castañeda, Silang, Cavite 4129. 3. DEADLINE FOR SUBMISSION OF APPLICATION: Sept. 2009. No WALK-IN applicants will be allowed to take the examination. 4. NOTICE OF EXAMINATION shall be sent through mail or visit: www.pnpa.edu.ph & www.ppsc.gov.ph for the list of examinees, place of examination, and test requirements. APPLY NOW : The PNPA Cadet Admission Test will be on October 2009, at the following areas. (Test Centers to be stated in your Notice of Examination) Region

AREAS

1

Laoag City San Fernando City, La Union Tuguegarao City Cauayan, Isabela Cabanatuan City San Fernando City, Pampanga Calamba City Lucena City Legaspi City Iloilo City Bacolod City Cebu City Tacloban City Zamboanga City Cagayan de Oro City Davao City General Santos City Taguig City Quezon City City of Manila Baguio City Butuan City Cotabato City Camarines Norte, Daet ISCAF, Nayon, Lamut, Ifugao

2 3 4A&B 5 6 7 8 9 10 11 12 NCR CAR CARAGA ARMM Camarines Norte Ifugao

CODE

MOTTO: TO LEARN TODAY, TO LEAD TOMORROW

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