NMAT IDENTIFICATION FORM

(Must be SUBMITTED to the Examiner on the day of the test)

Bank Reference Number : 2594513600 Name of Applicant : CARL STEPHEN BASTE PEREZ

NMAT Application Number : 1111302389

Mailing address : DOOR 1, SEAVIEW APARTMENT BOOL DISTRICT, Tagbilaran City, Bohol 6300 Philippines Name of College Graduating/Graduated From : [University of Bohol] Tagbilaran City, Bohol Month and Year Graduating/Graduated : March 2014 Test Center : Cebu City FOR THE APPLICANT: 1. Please attach a recent 2" x 2" colored picture (with white background and nameplate) on the box provided below. For GRADUATING college students, please have your School Head affix his/her signature on the lower front portion of the picture. For college GRADUATES, please bring a photocopy of your official Transcript of Records (TOR) and present it to the Examiner on the day of the test. 2. Bring this Form to the nearest Bank of the Philippine Islands (BPI) branch and pay the NMAT Registration and Test Fees (PhP1900.00 PHP) on or before November 04, 2013. Copy exactly the Bank Reference Number found on the upper left portion of this Form and CEM?s BPI account number 18810450-24 on the BPI Payment/Deposit Slip.. 3. Check your e-mail (including your spam mailbox) after two (2) banking days for your payment confirmation email. Visit also the NMAT Online website to verify the status of your NMAT application and to download the NMAT Practice Set and Supplementary Handout after payment has been confirmed. 4. You must also visit the NMAT Online website two weeks before the test date to know your room assignment and to download your Notice of Admission. 5. Affix your signature on the certification below:
I hereby certify that I have read, fully understand, and accept all the information, terms and conditions specified on the NMAT website www.cem-inc.org.ph/nmat, including the NMAT policies on refund of test fees and on failure to take or complete the test on the test date and test center indicated on this Form. I further certify that all information given 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 NMAT or invalidation of my NMAT results.

Test Date : November 24, 2013

Signature of the Applicant

Date Signed

FOR THE SCHOOL HEAD: Please affix your signature on the lower front portion of the picture (extending beyond the edges to prevent tampering) and on the space provided below to attest to the identity of the person getting your signature. I hereby certify that the person in the picture is one and the same as the NMAT applicant who is a candidate for graduation of this institution on the date he/she specified and whose signature appears above.
Printed Name and Signature of School Head Designation of School Head

PASTE HERE (DO NOT STAPLE) 2" x 2" COLORED PICTURE WITH NAMEPLATE

Date Signed

1111302389

Page 1 of 1

Downloaded on: Sep. 09, 2013 12:21am