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Registration Form: 1017123441 7mnwaeqa38

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27 views1 page

Registration Form: 1017123441 7mnwaeqa38

Uploaded by

lyandreiduero
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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NMAT REGISTRATION FORM

National Medical Admission Test (This Form will NOT be collected on test day)

Application No.: 1017123441 DUERO, LYANDREI GO


Reference No.: 7MNWAEQA38 Name of Applicant
(Name that will appear on your Examinee Report Form)

2003-08-14 Male Philippines Single


Birthdate Sex Nationality Civil Status
3102 BERKELEY RESIDENCE J ESCALER LOYOLA HEIGHTS, KATIPUNAN, QUEZON CITY, METRO MANILA 1105 Philippines

2 X 2 ID Picture Mailing Address (Address where your Examinee Report Form will be delivered)
N/A +63-9673396612 [email protected]
Landline No. Mobile No. Email Address

FOR FOREIGN APPLICANT

Passport No. Expiry Date Place of Issue


Test Location: Domestic
Test Date: October 20, 2024 1PM to 5PM

REMINDERS

A. PAYMENT
1. Payment instructions have been sent to your official email address. Please pay the exact amount indicated in your payment
instructions.
2. Only successfully paid applicants will be able to take the online NMAT. Make sure that applicable fees have been settled on or before
the date and time indicated in your payment instructions. Payment made beyond the holding period will not be honored.
3. Confirm the details of your transaction receipt. Keep the copy of proof of payment for future reference.
4. A surcharge fee of Php200.00 will be collected to process refund request due to over or double payment and processing of any special
request or correction (i.e. change of mailing address etc.)

B. REQUIRED DOCUMENTS
1. Email a PDF file of Transcript of Records (for graduate applicants) or Certificate to Graduate (for graduating applicants) to
[email protected] . Indicate in the subject line the following format:
Application Number_Complete Name_Scheduled Test Date.
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2. For updates, visit the website at www.cem-inc.org.ph/nmat.


Downloaded on: Sep 23, 2024 11:25pm

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