Republic of the Philippines

TARLAC STATE UNIVERSITY

OFFICE OF INTERNATIONAL AFFAIRS

Romulo Blvd., Tarlac City

Website: http://www.tsu.edu.ph

E-mail:

Telefax: 63459820110

APPLICATION FORM FOR INTERNATIONAL STUDENTS

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

Employer's Name / Post/Job title / Full Time or / Job description/ / From / To
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 thumbprint

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