SPUP-ETEAP-001

St. Paul University Philippines

Tuguegarao City, Cagayan 3500

EXPANDED TERTIARY EDUCATION EQUIVALENCY

AND ACCREDITATION PROGRAM

ETEEAP APPLICATION FORM

Recent 2x2
ID Picture

INSTRUCTIONS

Please type or clearly print your answers to all questions. Provide complete and detailed
information required by the questionnaire. Put a check mark in the appropriate box for specific
questions. All the declarations that you make are under oath. Discovery of any false claim in
this application form will disqualify you from participating in the program.

I. PERSONAL INFORMATION

Indicate in the proper order your last name, first name and middle name. Indicate your
complete address to include building number/name, street name, district, city and province
when applicable. Indicate the telephone number and the area code for areas outside Metro
Manila. Indicate complete birth date in this format: month, day, year. Indicate place of birth,
including city/municipality and province when applicable. Indicate all languages and
dialects spoken such as English, Filipino, Ibanag, Ilokano, Cebuano, Boholano, Bikolano,
etc.

Name:
(Last Name, First Name, Middle Name)

Address:
Zip Code:
Telephone / Mobile No(s):
Birth Date:
Birth Place:

Civil Status: Single Married Separated Widow Divorced

Sex: Male Female Nationality: Filipino Others:
Languages and Dialects Spoken:

Learning Objectives:

Under this section, you will be asked to assess your goals and capacity to undertake the
program. Please answer all the questions completely. For 1.10.1, select three degree
programs which you are most interested in pursuing, and rank them according to order of
preferences: first, second and third. In case you do not have any second or third priority,
leave them blank. In case two or more programs are of equal priority, indicate it also.
Please do not write more than three programs. For 1.10.2, please state your personal goal
statement for obtaining the degree, and how would you expect the ETEEAP’s system to
accreditation through assessment to help you tick off appropriate answer for the boxes or
field provided below:
1.10.1 Degree program or field being applied for:

1.10.1.1 First priority:

1.10.1.2 Second priority:
1.10.1.3 Third priority:

1.10.2 Statement of your goals, objectives or purposes for applying for the degree:


1.10.3 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.


1.10.4 For overseas applicants, describe how you plan to obtain accreditation / equivalency.
(e.g. when you plan to come to the Philippines)


1.10.5 Who will pay for the cost of obtaining your accreditation?

Self – financed Scholarship / grant

Company / employer financing Support from a member of the family

Loan Others (please specify):

1.10.6 How soon do you need to complete accreditation / equivalency?

Less than 1 year 1 year

2 years 3 years

4 years more than 5 years

II. EDUCATION

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

A. Formal Education

Include only dates you started and finished elementary school. Indicate the name and
address of every school you attended and the inclusive dates of attendance in each. In case you
attended and the inclusive dates of attendance in each. In case you attended high school abroad,
please indicate also whether the school is middle school, junior or senior high school, and the
inclusive dates of attendance in each of them. For those who obtained equivalency through
PEPT, please indicate the date they were certified, and the grade or year level you were placed.
Grades are from I to VI, Year is from 1st to 4th.

1. Elementary

Name of School & Address:

Inclusive Dates of Attendance:

2. High School
(If obtained outside Philippine educational system, please indicate the type of school.)
Name(s) and Address(es) of Schools Attended
2.1

Inclusive Dates of Attendance:

to

Note: Use another sheet if necessary.

3. If required High School diploma through Philippine Educational Placement Test

Equivalency.

Year Issued: Placement Grade or Year:

4. Post – Secondary Formal Education

COURSE/DEGREE PROGRAM
ENROLLED (e.g. Vocational, NAME OF INSTITUTION SCHOOL YEAR
Technical)

Note: All entries should be supported by authenticated Xerox copy of appropriate certificates /
documents obtained from the institution through the program.
 B. 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.

TITLE OF NATURE OF
TITLE OF TRAINING SPONSORING CERTIFICATE PARTICIPATION
DATE
PROGRAM ORGANIZATION OBTAINED (Trainer, Participant,
Facilitator, etc.)

Note: All entries should be supported by authenticated Xerox copy of appropriate certificates /
documents obtained from the institution through the program.

C. Other Certification Examinations

Please give detailed information on certification examination taken for vocational and
other skills.

TITLE OF
NAME & ADDRESS OF DATE
CERTIFICATION RATING
CERTIFYING AGENCY CERTIFIED
EXAMINATION

III.PAID WORK AND OTHER EXPERIENCES

This section will described the relevant work experiences you have and indicate the type
of learning obtained in the course, of your employment. Please use the questionnaire below and
write your experiences in chronological order. Include concurrently help positions such as
consultant, and part-time employment as well.

Give full title for each position / occupation. When promoted, place the next position
title in the next set. Indicate inclusive dates you occupied the position. Give the complete name
and address of the company. Give name of known surviving immediate supervisor. Otherwise,
give a name of surviving person who can attest to your performance as an employee in this
position. Please explain why you have to move on to next job, or transfer to another company.
In case of a promotion, simply say so. The response you give to this question will not be used to
rate your appropriateness as a candidate to the program. Please give details of the functions and
responsibilities you performed in this position.

In case you were self-employed, please write down three personal references who can
attest to your effectiveness in the trade or business you were involved in.
1.1 Post / Designation:

1.2 Inclusive Date of Employment

Day / Month / Year

From: to

1.3 Name and Address of Company



1.4 Terms / Status of Employment



1.5 Name and Designation of Immediate Supervisor



1.6 Reason(s) for Moving on to Next Job



1.7 Described actual functions and responsibilities in position occupied:



1.8 In case of self – employment, name three (3) reference persons:



(Use another sheets 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.

Please write full title of the award received. Indicate the name and most recent known
address of the organization or institution conferring the award / honor / citation. Give date the
award was conferred.

A. ACADEMIC AWARD

Name & Address of

AWARD CONFERRED Date Awarded
Conferring Organization
 B. COMMUNITY AND CIVIC ORGANIZATION AWARD / CITATION

Name & Address of

AWARD CONFERRED Date Awarded
Conferring Organization

C. WORK RELATED AWARD / CITATION

Name & 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 and 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.

Please provide a short description of your work / accomplishments and state why this
qualities as a special accomplishment. For example, cooking regular meals will not qualify as a
special accomplishment; however an occasion where you were called upon to display skill and
knowledge in preparing a wide range of native regional delicacies is a special accomplishment,
implying possession of a sophisticated understanding and internalization of regional culture,
science and art of regional cuisine, etc. Indicate date when special accomplishment was finished.
Indicate the name of a body or institution which can be called upon to corroborate your claim to
this accomplishment.

1.1 Description

1.2 Date Accomplished:

1.3 Name and Address of Publishing Agency (if written, published work), or an Association /
Institution which can attest to the quality of the work.


(Use additional sheet if necessary, following the same format.)

VI. LIFELONG LEARNING EXPERIENCES

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

A. Hobbies / Leisure activities:

Include only those leisure activities which can be considered learning opportunities.
For example, watching television soap opera cannot be considered a learning opportunity;
however, watching. Negosiyete on a regular basis can be considered a learning opportunity.

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.


B. Special Skills:

A special skill can be considered as an acceptable substitute for a specific credit

requirement. For example, ability to demonstrate the various styles of swimming is an
accepted substitute for one Physical Education class requirement. Note down those special
skills which you think must be related to the field of study you want to pursue.


C. Work – Related Activities

Some work-related activities are occasions for you to learn something new. For
example, being assigned to projects that are beyond your usual job description and requiring
other types of competence produces such results. Identify those tasks that can be considered
as new and through which you learned new skills and knowledge. Explain in detail what
new knowledge in other aspects of your work, thereby making you more effective on the job.
Please do not include, under this category, formal training programs you cited in section 2.
However, you may include here experiences which can be classified as on-the-job training or
apprenticeship.


D. Volunteer Activities (including those activities participated in as a member of a

professional or civic organization):

Choose only volunteer activities that also demonstrate learning opportunities. The
key to selecting volunteer activities to be included here is when those activities demonstrate
new knowledge and skills that related to the course are applying for credit. Select also those
organizations which can be validated and they must be accredited by a government
institution or the accrediting HEI. Volunteer activities which can be considered here are
counseling programs, sports coaching projects organizing or coordination, organizational
leadership, and the like.

 E. Travels: Cite places visited and purpose of travel.

Please enumerate places visited within and outside the Philippines. 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 experiences were obtained from these
travels and how it helped you become a better person.


VII. To sum up, please write and essay on the following topic, in the language you are
most comfortable with, not to exceed two pages of short size bond paper.
If you finish your degree, how will this contribute to your personal development,
to the development of your community, your work place, society and country?