CHED Form No. CEM 2 (Application Form)

Date ________________

REQUIREMENTS FOR THE ISSUANCE OF THE CERTIFICATE FOR ELIGIBILITY FOR ADMISSION INTO THE MEDICAL COURSE

TO BE FILLED UP BY THE APPLICANT

Name of the Applicant : ___________________________________

Permanent Address : ___________________________________

Mailing Address : ___________________________________

Name of (Pre-Med) School : ___________________________________

Address of (Pre-Med) School : ___________________________________

Degree Earned : ___________________________________

Date of Graduation : ___________________________________

Accepting Higher Education Inst. (HEI) ___________________________________

Address of Accepting HEI : ___________________________________

Requirements:

1. Photocopy of Passport 2. Certified True Copy of Transcript of Records from the school last attended 3. Copy of Diploma or Certification of graduation authenticated by the Registrar of the school

where graduated 4. Notice of Acceptance indicating the quota number of the student issued by the HEIs 5. National Medical Admission Test (NMAT) result

Schedule of the Availability of Service: Monday to Friday : 8:00 am to 5:00 pm

Fees: Php 80.00 per CEM

Total/Maximum Duration of Process: Three (3) Days

Procedure:

1. Files the application to the Student Assistant and Service Division (SASD) Staff, Office of Student Services (OSS)

2. Pays the fee to the Cashier

3. Submits O.R. to SASD and receives instruction when to claim the CEM

4. Comes back to OSS to claim the CEM on the specified date of release

Office of the President of the Philippines COMMISSION ON HIGHER EDUCATION

OFFICE OF STUDENT SERVICES 3/F H.E.D.C. Building, C.P. Garcia St., UP Diliman Quezon City

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