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UNIVERSITY OF THE EAST Picture

APPLICATION FORM
(UE-TAN YAN KEE FOUNDATION, INC. SCHOLARSHIP)

NAME:__________________________________________________________________________
(Last Name) (First Name) (Middle Name)
Date of Birth: _________________ Place of Birth:________________________________________
Age (as of last birthday):________ Citizenship:_______________ Sex: Male  Female 
Address (City):_______________________________ Tel. No. __________ Mobile No.___________
Address (Province):___________________________ Tel. No. __________ Mobile No.___________
High School Attended:______________________________________________________________
(Name of School/Address)
rd
General Weighted Average (as of 3 Quarter):__________
Average Grade (as of 3rd Quarter) in English ___________ Math __________ Science __________
Special Skills/Talents: ______________________________________________________________
Club/Organization/Society Membership(s):______________________________________________
Position:_________________________________________________________________________
Course to Pursue: _________________________________________________________________
Father Mother
Name of Parents : ______________________ ______________________
Occupation/Name of Company : ______________________ ______________________
Highest Educational Attainment : ______________________ ______________________
School Attended : ______________________ ______________________
Annual Income : ______________________ ______________________
I hereby certify that the above information/statements are true to the best of my knowledge.
___________________ ___________________________
Date (Signature over printed name)
Please call the Admissions Office at the following numbers for the schedule of the qualifying tests:
735-8577 or 735-5471 locals 398 or 399
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Please attach the following: This scholarship is awarded to qualified incoming freshmen
1. Photocopy of 4th Year HS Card with General Weighted who intend to pursue a degree in any of the following
Average (as of 3rd quarter) disciplines:
2. Accomplished application form. 1. Science/Mathematics
3. 2x2 picture (2 pcs.) 2. Accountancy
4. Self Addressed Envelope with Stamp 3. Computer Science/Information Technology
4. Dentistry
5. Engineering
6. English/Communication Arts
Submission beginning Jan. 7-31, 2013 (Mon. to Fri. ONLY)

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