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COLLEGE OF LAW

UNIVERSITY OF THE PHILIPPINES

Passport size.
Sign name at
back of photo.

Application for Admission to the


Juris Doctor (J.D.) Program for 2011-2012

(All sections must be completed and received by 12 November 2010 (without fine) or 19 November 2010
(with fine). Attach separate sheet if needed. For inquiries or information: Tel. No. 927-7180;
http://law.upd.edu.ph; or visit the Office of the College Secretary, 1st Floor, Malcolm Hall, Diliman, Quezon City.)
Full Name __________EJERCITO____________________KHRISTINE
JANE______________________BERTEZ_____________
(Last)
(First)

(Middle)

Mailing Address (Where you would like correspondences


to be sent.)
Street
# 2 RD. 11 GSIS HILLS
SUBD,__________
City
NOVALICHES, QUEZON
CITY_________
Province
____________________________________
Region
NATIONAL CAPITAL
REGION________
Country
PHILIPPINES________________________
Zip
1116__
Landline(s)
(02) 931
7885________________________
Cellphone(s) +63 (917) 848
5263____________________
E-mail(s)
kjejercito@yahoo.com_________________

month / day / year

Permanent Home Address


Street
# 2 RD. 11 GSIS HILLS
SUBD,__________
City
NOVALICHES, QUEZON
CITY_________
Province
____________________________________
Region
NATIONAL CAPITAL
REGION________
Country
PHILIPPINES________________________
Zip
1116__
Citizenship
FILIPINO___________________________
Place of Birth QUEZON CITY___________________
Date of Birth JANUARY 19,
1988___________________

Sex: Female
Male
Status:
Single
Married

Separated/Divorced
List all elementary schools, high schools, colleges, universities, graduate and professional schools that you
have attended:
honors

School

Place

Period of attendance

Degree

University of the
Philippines
University of the
Philippines
Quezon City Science HS

Diliman

2010 Present

Master

Manila

2004 2008

BA

QC

2000 2004

Placido Del Mundo ES

QC

1994 2000

Major

International
Studies
Social Science

Scholastic

Best Thesis, CS
2nd Place
Sportswriting
Honorable Mention

Yes No
Have you ever been charged with or convicted of an offense in any criminal or
administrative case(s)?
If
yes,
give
particulars:
_________________________________________________________________
______________________________________________________________________________________
Yes No
Have you ever been dismissed/disqualified from enrolling in a school by reason of
scholastic delinquency or disciplinary action? If yes, give particulars:
______________________________________________________________________________________
______________________________________________________________________________________
Yes No
Have you ever enrolled in any law school, including the U.P. College of Law?
If yes, attach your Official Transcript of Records from the law school(s).
Yes No
Have you taken the LAE before?
If yes, indicate the number of times and the year(s) taken. __________
Yes

No
Have you or are
enrolled
in a LAE review
program?
*NOTE: Credentials/documents
filedyou
pursuant
to application
requirements
become the property of the U.P.
If yes, indicate where and what review center:
____________________________________________
What
languages
do
you
ENGLISH_______________________________________________________

speak?

_FILIPINO,

Where will you take the LAE?


UP Diliman
UP Cebu

UP Baguio
UP Davao

UP Visayas (Iloilo City)

If admitted, what are the mean(s) by which you will support yourself? (check all applicable)
Self-supporting
Private scholarship
Parents
Government scholarship
Others
_____________________________
If admitted, where do you plan to enroll?
Program

Day Program

Five-Year Evening

How much is your familys gross yearly income? __________


On pain of perjury, I certify under oath that the information I have provided on this application form
and in any attached materials are accurate to the best of my personal knowledge. I understand that the UP
College of Law may verify information included in my application. I hereby authorize the U.P. College of
Law to access any of my official records to verify the accuracy of any information supplied herein. I agree
to notify the U.P. College of Law of any changes in the above information or of any further information that
might affect my eligibility for consideration as a prospective student.
_______________________________________________
Signature of Applicant

__________________________________________
Date

-------------------------------------------------------------------------------------------------------------------------------------------------------------1. 2 lead pencils (No. 1 Mongol)


ADMISSION TICKET
2. Admission Ticket
(Examiners Copy)
3. Identification Card (Photo bearing School ID,
Employees Photo ID, Drivers License, Passport
Application No. _________________
or Photo bearing Certification from School
Passport size.
Place:_________________________
Registrar or Employer)
Sign name at
Date : 21 November 2010
back of photo.
Time : 7:30 A.M.
Name________________________________________________
Mailing Address______________________________________
Bring the following for the examination:
______________________________________________________

By: _________________
Date: _________________
(To be filled in by the Admissions Committee
Chairperson)

ADMISSION TICKET
(Applicants Copy)
Application No. ________________________
Place:________________________________
Date : 21 November 2010
Time : 7:30 A.M.

Passport size.
Sign name at
back of photo.

Bring the following for the examination:


1.
2.
3.

2 lead pencils (No. 1 Mongol)


Admission Ticket
Identification Card (Photo bearing School ID,
Employees Photo ID, Drivers License, Passport
or Photo bearing Certification from School
Registrar or Employer)

Name
____________________________________________________
Mailing
Address
__________________________________________
_________________________________________________________
_
By: ______________________________
Date:
_____________
(To be filled in by the Admissions Committee
Chairperson)