ADMISSION EXAM FORM PRINT CLEARLY ALL INFORMATION IN THIS APPLICATION FORM.
Name:______________________________________________________________________ Mobile No.:____ __________________ Age:______ __________________ Sex:________ Home address: _____________________________________________________________________________________________ | __________________ __________________________ ________ (Street/Barangay ) ( Municipality/City Municipality/City)) ( Province) Province) ( Zip Zip Code) Code) ( Email Email ) Date of Birth: ____________________
Senior High School Attended: __________________________________________________________________________| _____ Public ____ Private Senior High School Address: ____________________________________________________________________________________________________ SHS Track: _____ STEM
____ABM
____HUMSS
____SPORTS
____TVL
____ARTS & DESIGN
____GAS ____ GAS
Preferred VSU Campus: (Check only one)
______ VSU Main (Baybay)
______ Alang-alang
Isabel ______ Isabel
______ Tolosa
______ Villaba
Undergraduate Degree Programs (Please mark [/] preferred degree on the blank.)
(VSU-Main) ____ Bachelor of Arts (English Language) ____ Bachelor of Culture and Arts Education ____ Bachelor of Early Childhood Education ____ Bachelor of Elementary Education ____ Bachelor of Science in Agribusiness ____ Bachelor of Science in Agricultural and Biosystems Engineering ____ Bachelor of Science in Agriculture (*Agronomy *Agricultural Economics *Agricultural Botany *Agricultural Extension *Animal Science *Horticulture *Plant Breeding *Plant Protection *Soil Science) ____ Bachelor of Science in Agricultural Chemistry ____ Bachelor of Science in Biology (*Botany *Ecology *Marine Biology) ____ Bachelor of Science in Biotechnology ____ Bachelor of Science in Civil Engineering ____ Bachelor of Science in Chemistry ____ Bachelor of Science in Computer Science ____ Bachelor of Science in Development Communication ____ Bachelor of Science in Development Education ____ Bachelor of Science in Economics ____ Bachelor of Science in Environmental Management ____ Bachelor of Science in Environmental Science ____ Bachelor of Science in Exercise and Sports Science ____ Bachelor of Science in Food Technology ____ Bachelor of Science in Forestry ____ Bachelor of Science in Geodetic Engineering ____ Bachelor of Science in Hotel Management ____ Bachelor of Science in Marine Biology ____ Bachelor of Science in Mechanical Engineering ____ Bachelor of Science in Nursing ____ Bachelor of Science in Statistics ____ Bachelor of Science in Tourism Management ____ Bachelor of Secondary Education ____ Bachelor of Physical Education ____ Doctor of Veterinary Medicine
(VSU - Alang-alang) ___ Bachelor of Science Science in Environmental Management Management ___ Bachelor of Secondary Secondary Education ___ Bachelor of Elementary Elementary Education ___ Bachelor of Agricultural Agricultural Technology ___ Diploma in in Agricultural Technology (VSU - Isabel) ___ Bachelor of Secondary Secondary Education ___ Bachelor of Elementary Elementary Education ___ Bachelor of Science in in Information Technology ___ Bachelor of Science in in Industrial Engineering ___ Bachelor of Science in in Agribusiness ___ Bachelor of Science in in Mechanical Engineering Engineering ___ Diploma in Associate in Computer-Technology (ACT) ___ Diploma in in Trade Technical Education (TTE) (TTE) (VSU - Tolosa) ___ Bachelor of Science Science in Fisheries ___ Bachelor of Secondary Secondary Education ___ Bachelor of Elementary Elementary Education ___ Bachelor of Science Science in Criminology ___ Bachelor of Science Science in Biology (VSU - Villaba) ___ Bachelor of Science Science in Agriculture ___ Bachelor of Agricultural Agricultural Technology ___ Bachelor of Elementary Elementary Education ___ Bachelor of Secondary Secondary Education
I HEREBY CERTIFY that all information provided herein are true and correct to the best o f my knowledge.
_____________________________ ________ Signature over Printed Name
Date: _______________
Requirements Checklist: 1. Application Form 2. School Identification Card or any valid ID with photo (ex. Driver’s License, Voter’s Voter’ s ID, Passport) 3. High School Card (if graduated), Certification of Grades and GPA for 3 rd Grading Period or 2nd Grading Period for schools which opened in August issued by the Principal (if continuing Grade 12 student)
EXAMINATION PERMIT
This is to certify that ______________________________________________ of_____________________________________________ School, ___________________________________________ __________(Address) has complied with all the requirements requirements for the VSU Admission Test and is hereby issued this test permit.
_______________________________________ ______ Name & Signature Signature of the Testing Coordinator Coordinator
____________________________ Signature of the Examiner Examiner