PhiLSAT

Philippine Law School Admission Test

IDENTIFICATION (ID) FORM
(Must be SUBMITTED to the Watcher on the day of the test)

Application No.: 2041804228 CUADRILLERO, JC MAE GELI

Bank Reference No.: 15888 Name of Applicant (Name that will appear on your Answer Sheet and Certificate of Eligibility or Certificate of Grades)
1995-05-28 Female Philippines Single
Birthdate Sex Nationality Civil Status
Surigao Del Sur State University - SSIT Cantilan, Cantilan, Surigao Del Sur
Name of College/University Graduated From
Surigao del Sur Philippines
Province/State of College/University Graduated From Country of College/University Graduated From
BS in Business Administration 2015-2016 N/A
2 X 2 ID Picture College Course (Bachelor’s Degree) School Year Graduated Postgraduate Status

TRUGILLO, BAYBAY (POB.), CARRASCAL, SURIGAO DEL SUR 8318 Philippines

Permanent Address

TRUGILLO, BAYBAY (POB.), CARRASCAL, SURIGAO DEL SUR 8318 Philippines

Mailing Address
N/A +63-9957298702 cuadrillerojc28@gmail.com
Landline No. Mobile No. Email Address
Test Location: Cebu City N/A N/A
Test Date: April 08, 2018 Name of Employer/Company Type of Employer/Company
Results to be: Sent via postal mail N/A N/A
Address of Employer/Company Type of Employment
Test results and ID information released to
FOREIGN APPLICANT
requesting law schools? Yes
N/A N/A N/A
Law School Choices: Passport No. Expiry Date Place of Issue
1st: Father Saturnino Urios University PERSON WITH DISABILITY (PWD)
2nd: San Sebastian College-Recoletos N/A N/A
PWD Card No. Type of Disability/Impairment
3rd: Southwestern University
N/A
What special assistance/arrangement do you require on the day of the test?
MEDICAL CONDITION
None N/A
Do you have a medical condition? Describe the medical condition
N/A
What special assistance/arrangement do you require on the day of the test?
FOR THE PhiLSAT APPLICANT
1.  Affix your signature on the certification below.

I hereby certify that I have read, fully understood, and accepted all the information, terms and conditions specified on the PhiLSAT website www.cem-inc.
org.ph/philsat, including, among others, the PhiLSAT policies on allowed and prohibited items, on cheating or improper test-taking behaviour in any manner
or form, and on failure to take or complete the test on the test date and testing location indicated on this Form. I further certify that all information I gave on this
Form is true and correct to the best of my knowledge and that any misinformation shall constitute grounds for my disqualification from taking the PhiLSAT or
invalidation of my PhiLSAT results.

Applicant’s Signature Date Signed

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2.  Visit the PhiLSAT website to verify the status of your PhiLSAT application.
3.  Visit the PhiLSAT website two weeks before the test date to know your room assignment and to download your Examination Pass.
Downloaded on: Feb 27, 2018 03:31pm

4.  Secure from the office of your College/University Registrar a Certificate of Graduation OR an original or certified true copy of your Transcript of Records (TOR)
as proof that you GRADUATED from the college/university with the college degree course and in the school year indicated on this Form.

On the day of the test, you must bring and submit to your Watcher this PhiLSAT ID Form AND a Certificate of
Graduation OR an original or certified true copy of your Transcript of Records (TOR). Your PhiLSAT results
shall be withheld indefinitely if you fail to submit any of these two requirements.

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