phisat m.racelis

PhiLSAT IDENTIFICATION(ID)FORM

Philippine Law School Admission Test (Must be SUBMITTED to the Watcher on the day of the test)

Application No.: 2091904645 RACELIS, MELCHOR DELACRUZ
Bank Reference No.: 3892963814
Name of Applicant
(Name that will appear on your Answer Sheet and Certificate of Eligibility or Certificate of Grades)

1971-09-24 Male Philippines Single

Birthdate Sex Nationality Civil Status

PUROK 3, GUINACUTAN, VINZONS, CAMARINES NORTE 4603 Philippines

2 X 2 ID Picture Mailing Address (Address where your Certificate of Eligibility will be delivered)

N/A +63-9071373596 [email protected]

Landline No. Mobile No. Email Address

FOREIGN APPLICANT N/A N/A

N/A Expiry Date Place of Issue

Passport No.

Test Location: Manila
Test Date: September 29, 2019

REMINDERS

1.  You are NOT completely registered or fully qualified to take the PhiLSAT if you have NOT paid the testing fee even if you received you
PhiLSAT ID Form.

2.  You should NOT pay via online or mobile fund transfers or via ATM deposit. These transactions are NOT automatically traceable to your
PhiLSAT application. Your name may NOT be included in the room assignments and you may NOT be able to take the test..

3.  You can pay thru over-the-counter bank deposit by following these steps:

3.1 Bring this Form to the nearest Bank of the Philippine Island (BPI) branch OR Banco de Oro (BDO) branch for reference and pay
the full amount of (PPhHPP__10_0_0_._0_0_) on or before ______A_u_g_u_s_t _1_8,_2_0_1_9______.

3.2 Copy the Bank Reference Number found on the upper left portion of this form and fill-up the bank’s deposit slip. Write the
account name or merchant’s name Center for Educational Measurement, Inc. Indicate the applicable bank account number:

BPI current account number 1881-0450-24

OR

Downloaded on: Aug 02, 2019 08:24pm Page 1 of 1 BDO savings account number 0048-8008-5327

3.3 Confirm the details of your transaction before proceeding to the counter. Do NOT lose your proof of payment, deposit slip or
transaction acknowledgement.

4.  Check your email including your spam mailbox after three (3) banking days for your payment confirmation.

5.  Visit the PhiLSAT website to verify the status of your application.

6.  Visit the PhiLSAT website at least a week before the test date to know your room assignment and to download your Examination Pass. You
are required to bring the Examination Pass for submission on test day. In case your Examination Pass is not received three (3) days
before the test day, you should contact the PhiLSAT Secretariat immediately.

7.  Keep this form for your records. You may need it for future reference. This form will NOT be collected on test day.

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