PNPA CAT Application Form Revised 2012-A PNPA REGIST

PHILIPPINEPHILIPPINEPHILIPPINEPHILIPPINE NATIONAL POLICE ACADEMYNATIONAL POLICE ACADEMYNATIONAL POLICE ACADEMYNATIONAL POLICE ACADEMY Camp General Mariano N Castaneda, Silang, Cavite 4129

Tele Fax # (049) 545-5939/ (0939) 9393769 Website: www.pnpa.edu.ph Email Add: info@pnpa.edu.ph

APPLICATION FOR CADET ADMISSION TEST (IMPORTANT: READ THE INSTRUCTIONS AT THE BACK OF THIS PAGE BEFORE ACCOMPLISHING THIS APPLICATION FORM.) SURNAME FIRST NAME MIDDLE NAME

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“ TO LEARN TODAY, TO LEAD TOMORROW” (REPRODUCTION OF THIS FORM IS ALLOWED)

Application form can be downloaded at www.pnpa.edu.ph

SEX . MALE FEMALE

AGEE

WEIGHT(kg) CIVIL STATUS SINGLE SINGLE PARENT SEPARATED MARRIED WIDOWED ANNULLED

HEIGHT 5 BELOW 5’2

BELOW 5’4 COMPLETE MAILING ADDRESS with ZIP Code: 5’2

5’3 5’4

BIRTHDATE(date/month/year)

BIRTHPLACE (city/town/province) CITIZENSHIP 5’5 5’6 5’7

FAMILY BACKGROUND FATHER’S NAME:____________________________ CONTACT NUMBER:_______________ ADDRESS: _________________________________________________________________ MOTHER’S NAME:___________________________ CONTACT NUMBER: ______________ ADDRESS: _________________________________________________________________ GUARDIAN’S NAME: _________________________ RELATIONSHIP:___________________ ADDRESS: _________________________________ CONTACT NUMBER:_______________

5’8 5’9 5’10 5’11 6’0 ___ OTHERS

EDUCATIONAL ATTAINMENT COLLEGE/VOCATIONAL HIGH SCHOOL LEVEL: 1ST 2ND 3RD 4TH 5TH Year Graduated:____________ SCHOOL________________________________ SCHOOL:___________________________________________________ GENERAL AVERAGE (RATING):_______________ COURSE: ___________________________________________________ ACADEMIC AWARDS: _____________________ ACADEMIC AWARDS: _________________________________________ OTHER AWARDS:_________________________ OTHER AWARDS: ____________________________________________ CIVIC ORGANIZATIONS/AFFILIATION:_________________________ POSITION HELD: _______________________________ SPORTS : _________________________________ HIGHEST SPORTS ACHIEVEMENT: _________________________________ OTHER SKILLS:___________________________________________________________________________________________ Have you ever been dismissed from any employment, forced to resign or otherwise disciplined as a result of an administrative case, or convicted for any violation of law, ordinance or regulations before any civil court and/or military tribunal? YES NO If YES, please attach copy of the decision. Do you have any pending criminal or administrative case or civil case on file before any Prosecutor’s Office or Court of Justice or other derogatory record(s)? YES NO Do you have any parental and/or financial obligation, or have sired a child or children? YES NO 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. __________________________ (Signature of Applicant) NOTICE OF EXAMINATION OR ADMISSION NOTICE from the PNPA REGISTRAR shall be sent through mail. Applicants who fail to receive notice of examination may visit the PNPA website at www.pnpa,edu.ph to check if he/she is included in the List of Qualified Examinees. If found qualified, applicants may go directly at the designated examination areas on the date of examination even without the notice of examination. Applicants shall present valid personal identification cards (ID’s) together with other requirements.

EMAIL ADDRESS: ___________________ ___________________ TEL/LANDLINE NUMBER: ___________________ ___________________

MOBILE PHONE NUMBER: ____________________ ____________________

RECENT PHOTO IN PASSPORT SIZE WITH NAME

TAG AND WHITE BACKGROUND (DIGITAL

PHOTO IS NOT ACCEPTED)

INSTRUCTIONSINSTRUCTIONSINSTRUCTIONSINSTRUCTIONS

Please read instructions carefully. Be sure to meet the qualification requirements. Inaccurate or incomplete information will be ground for disqualification. SUBMIT ONLY ONE (1) APPLICATION.

1. REQUIREMENTS FOR ADMISSION: (DO NOT APPLY if you are NOT QUALIFIED) • Natural born Filipino citizen; • Of good moral character; • No financial obligations; • Male or female, single and with no parental obligation; • 17 to 21 years old at the time of admission; • Preferably 5feet 4inches in height for male, and 5feet 2inches for female except for indigenous people; • Weight must not be more than or not less than five (5) kilograms of the standard weight corresponding

to height, age, and sex; • At least high school graduate; • Must be able to pass the minimum required physical fitness exercises:

Exercises Male Female Pull-Ups 3 Full Arms Hanging 30seconds Push-Ups(2 minutes) 15 10 Sit-Ups (2 minutes) 30 25 100 meter dash 18seconds 20seconds 3 km run 27minutes 30minutes

• Physically and mentally fit for cadetship training; • Have no criminal, administrative, or civil case and other derogatory record(s); • Must not be a former cadet of PNPA or other service academies;

2. GROUNDS FOR MEDICAL DISQUALIFICATIONS:

• Defective Visual Perception (color blindness, near sighted/far sighted with corrective eyeglasses or lens, nystagmus); • Physical Deformities (bowlegged or congenital defects) • Perforated ear drum, chronic sinusitis, bleeding tendencies, hemorrhoids, hernia (if not treated), varicocoele,

extensive skin disorders; • History of heart disease, hypertension, asthma, active PTB, kidney and liver diseases, epileptic seizure disorders,

major operations; sexually transmitted infection such as AIDS, Hepatitis, VD etc. • Full dentures, upper and lower, Cleft lip and palate, malocclusion, Deformities of the face, Open bite, Tongue-tied,

missing of four(4) anterior or front teeth & Missing of six (6) posterior/molar teeth; • Tattoos and other brotherhood marks, ear piercing (male only); • For Females: Goiter; History of pregnancy; Presence of breast mass; Painful menstruation; • Any other similar defects which may hinder in the Cadetship Training Program.

3. The PNPA Cadetship Program is a government Scholarship Program. Admitted Cadets must complete the Cadetship Program and serve the government either in the PNP, BFP or BJMP services for the prescribed period (two years of service for every year of scholarship). Cadets shall reimburse the government expenses for his/her scholarship should he/she fail to complete the Cadetship Program.

4. COVERAGE OF EXAMINATION

• Communication Skills • Logical and Reasoning Ability • Math and Sciences

• General Information and Current Events • Values and Aptitude for the Service

5. Submit duly accomplished application together with a self-stamped WINDOW ENVELOPE to the Office of the Registrar or mail to: The Director, (Attn: Registrar), Philippine National Police Academy, Camp General Mariano N Castañeda, 4129 Silang, Cavite.

6. DEADLINE FOR SUBMISSION OF APPLICATION: September 24, 2012 PNPA Cadet Admission Test will be on October 28, 2012 7. PLEASE CHOOSE YOUR TEST CENTER PREFERENCE INDICATED BELOW. PUT A CHECK ON THE BOX BESIDE THE TEST CENTER CODE.

TEST CENTER PREFERENCE REGION LOCATION CODE REGION LOCATION CODE

I Vigan City 001 VII Cebu City 013

Dagupan City 002 VIII Tacloban City 014

II Tuguegarao City 003 Catarman, Northern Samar 030

Cauayan, Isabela 004 IX Zamboanga City 015

III Cabanatuan City 005 Pagadian City 027

City of San Fernando, Pampanga 006 X Cagayan de Oro City 016

IV A & B Calamba City 007 XI Davao City 017

Lucena City 008 XII General Santos City 018

Odiongan, Romblon 025 NCR Quezon City 019

Dasmariñas City 029 Manila 020

V Legazpi City 009 CAR Baguio City 021

Naga City 010 Lamut, Ifugao 022

VI Iloilo City 011 CARAGA Butuan City 023

Bacolod City 012 ARMM Cotabato City 024

Kalibo, Aklan 026 Bongao, Tawi-Tawi 028