NAPOLCOM Form 1-A (Examination Form)

Revised 01-10
Republic of the Philippines
NOT FOR Department of the Interior and Local Government
SALE NATIONAL POLICE COMMISSION
____________________________
___________________________

PNP ENTRANCE EXAMINATION

DATE OF EXAMINATION: ___________________
APPLICATION NUMBER
Direction: Fill up this form in PRINT / BOLD letters.
1. NAME
DESLATE PRETCHIL
BORNALES
____________________________ ______________________________________ ______
___________________
Last Name First Name
Middle Name

2. PERMANENT/MAILING ADDRESS 3. ZIP CODE

SILWAY 8 POLOMOLOK SOUTH COTABATO 9504
4. CONTACT NUMBER 5. GENDER
6. DATE OF 7. AGE 8. CIVIL 9. RELIGION
(LANDLINE/CELLPHONE) ( )M
BIRTH STATUS
0909465249 ( )F
(mm/dd/yyyy 21 ROMAN
) SINGLE CATHOLIC
APRIL
16,1990
10. HIGHEST EDUCATIONAL ATTAINMENT 11. NAME OF SCHOOL
(Write the complete title of course / degree /
program and year graduated) FILAMER CHRISTIAN
BACHELOR OF SCIENCE IN COMPUTER UNIVERSITY
SCIENCE
12. EMPLOYMENT RECORD (FOR PNP MEMBERS ONLY)
Present Rank Status of Current No. of Years in No. of Years in the
Appointment Assignment Present Rank Police Service

FOR NAPOLCOM PROCESSOR ONLY

13. WEIGHT 14. HEIGHT (in Height measurement taken Date NOTE: For under
meters) height applicants, who
(in kg) by: Measured:
are members of the
“54” “153”
ICC, attach NCIP/OMA
_____________________________ Certificate of
__ Confirmation.
Signature over Printed Name

15. Have you taken the PNP Entrance examination before? _____ “YES”, how many times?
_________ _____ “NO”

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I declare under oath that this application has been accomplished in good faith, verified by me
and to the best of my knowledge and belief, is a true, correct, and complete statement pursuant to
the provisions of pertinent laws, rules, and regulations of the Republic of the Philippines.
I am also fully aware that when I violate any of the rules and regulations of the examination, I
will be automatically disqualified and/or my examination results be automatically nullified.
 Signature of Applicant
( ) APPROVED ( ) DISAPPROVED

EXAMINATION
Application Processor: ________________________ Right Thumbmark

NAPOLCOM
STAMP
NOTICE OF ADMISSION

INQUIRY ON TEST RESULTS

You can log on to the NAPOLCOM web

address at www.napolcom.gov.ph. To avail
of the TEXT NAPOLCOM facility, please text-
in:
NAPOLCOM space EXAMRSLT space
APPLICATION NUMBER
or
NAPOLCOM space EXAMRSLT space LAST
NAME/FIRSTNAME/MIDDLENAME
and send to:
a) 2256 for Globe and Touch Mobile
b) 6808 for Smart and Talk ‘n Text
c) 2269 for Sun Cellular