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Republic of the Philippines


Romulo Blvd., Tarlac City
Website: http://www.tsu.edu.ph
E-mail: registrar@tsu.edu.ph
Telefax: 63459820110


Application Fee: US$ 25

1. Personal details

Family Name: ________________ Given Name (s) _______________________________

Sex: ____________ (Male/Female) Date of Birth (Day/Month/Year) _________________

Country of Birth: ___________________ Country of Residence: _____________________
Nationality:___________________________ Passport No.: _________________________
Native Language ___________________________________________________________
Current Address: ___________________________________________________________
______________________________________________ Post Code: __________________
Telephone No:_________________________ Mobile Phone No: _____________________
Fax No: ____________________________ E-mail _______________________________
Emergency address and phone number in your country _____________________________

2. Programme Preferences
Preferred semester:
First Semester (June–Oct.)_____________ Second Semester (Nov.- March) ______________
Summer (April-May) _____________________________________ (Year) ______________
Preferred programme/area of study: _____________________________________________
Level of study (Doctoral, Master, Baccalaureate, Diploma, etc.): _____________________
3. Educational Background

Institution and Place Year (From-To) Field of Study Degree Conferred

4. Work Experience

Full Time Job

Employer's Post/Job
or description/ From To
Name title
Part Time responsibilities Month/Year Month/Year

5. Language Proficiency
Please provide any evidence of your ability in the use of English language and enclose
photocopies of your certificates if available.

Language you studied Length of study Speaking Writing Reading

6. Further Information
Please provide information on your reasons for choosing the programme/area of study
and any relevant experience and interests:
7. Checklist
I have included in this application form
6 copies of Student’s Personal History Statement (PHS) duly signed with right and left
Transcript of Records/Scholastic Records with English translation, duly notarized and
authenticated by the Philippine Foreign Service Post (PFSP) or Philippine Embassy
Notarized Affidavit of Support including bank statements or notarized notice of grant for
institutional scholars
Photocopy of passport showing date and place of birth
Birth certificate or its equivalent duly authenticated by the PFSP
2 x 2 photos on plain white background taken not more than 6 months prior to submission
Overseas Student’s Insurance (Accident and Sickness)*
*Required upon admission to TSU

8. Declaration
I declare that the information provided in this application is correct and true.

Signature: ______________________________ Date: ________ / _________ / _________

Send your complete application form to:

The Director
Office of International Affairs
Tarlac State University
Romulo Boulevard, Tarlac City
2300 Philippines