PhiLSAT

Philippine Law School Admission Test

IDENTIFICATION (ID) FORM
(Must be SUBMITTED to the Watcher on the day of the test)

Application No.: 2041804762 VALDEZ, RAY JOSHUA BAUTISTA

Bank Reference No.: 2000014651 Name of Applicant (Name that will appear on your Answer Sheet and Certificate of Eligibility or Certificate of Grades)
1993-08-23 Male Philippines Single
Birthdate Sex Nationality Civil Status
San Sebastian College - Recoletos, Manila City, Metro Manila (NCR)
Name of College/University Graduated From
Metro Manila (NCR) Philippines
Province/State of College/University Graduated From Country of College/University Graduated From
AB in Political Science 2013-2014 N/A
2 X 2 ID Picture College Course (Bachelor’s Degree) School Year Graduated Postgraduate Status
19 VALDEZ RESIDENCE GOLDENFARM STREET PACITA 2 BARANGAY SAN VICENTE, SAN VICENTE, SAN PEDRO CITY, LAGUNA 4023 Philippines
Permanent Address
19 VALDEZ RESIDENCE GOLDENFARM STREET PACITA 2 BARANGAY SAN VICENTE, SAN VICENTE, SAN PEDRO CITY, LAGUNA 4023 Philippines
Mailing Address
N/A +63-9069368412 zedjoshee@yahoo.com
Landline No. Mobile No. Email Address
Test Location: Manila N/A N/A
Test Date: April 08, 2018 Name of Employer/Company Type of Employer/Company
Results to be: Sent via postal mail N/A N/A
Address of Employer/Company Type of Employment
Test results and ID information released to
FOREIGN APPLICANT
requesting law schools? Yes
N/A N/A N/A
Law School Choices: Passport No. Expiry Date Place of Issue
1st: University of the Philippines - Diliman PERSON WITH DISABILITY (PWD)
2nd: San Sebastian College-Recoletos N/A N/A
PWD Card No. Type of Disability/Impairment
3rd: San Beda College
N/A
What special assistance/arrangement do you require on the day of the test?
MEDICAL CONDITION
None N/A
Do you have a medical condition? Describe the medical condition
N/A
What special assistance/arrangement do you require on the day of the test?
FOR THE PhiLSAT APPLICANT
1.  Affix your signature on the certification below.

I hereby certify that I have read, fully understood, and accepted all the information, terms and conditions specified on the PhiLSAT website www.cem-inc.
org.ph/philsat, including, among others, the PhiLSAT policies on allowed and prohibited items, on cheating or improper test-taking behaviour in any manner
or form, and on failure to take or complete the test on the test date and testing location indicated on this Form. I further certify that all information I gave 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 PhiLSAT or
invalidation of my PhiLSAT results.

Applicant’s Signature Date Signed

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2.  Visit the PhiLSAT website to verify the status of your PhiLSAT application.
3.  Visit the PhiLSAT website two weeks before the test date to know your room assignment and to download your Examination Pass.
Downloaded on: Mar 01, 2018 08:58pm

4.  Secure from the office of your College/University Registrar a Certificate of Graduation OR an original or certified true copy of your Transcript of Records (TOR)
as proof that you GRADUATED from the college/university with the college degree course and in the school year indicated on this Form.

On the day of the test, you must bring and submit to your Watcher this PhiLSAT ID Form AND a Certificate of
Graduation OR an original or certified true copy of your Transcript of Records (TOR). Your PhiLSAT results
shall be withheld indefinitely if you fail to submit any of these two requirements.

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