This document is an application for the Southern Luzon State University (SLSU) College Entrance Examination. It requests information from the applicant such as name, date of birth, contact details, high school attended, intended campus and course, and disability information. It also contains certification that the applicant has read the information bulletin, that all information provided is true and accurate, and that they will abide by test administration rules. The applicant must sign to confirm the information and their understanding of the examination policies.
This document is an application for the Southern Luzon State University (SLSU) College Entrance Examination. It requests information from the applicant such as name, date of birth, contact details, high school attended, intended campus and course, and disability information. It also contains certification that the applicant has read the information bulletin, that all information provided is true and accurate, and that they will abide by test administration rules. The applicant must sign to confirm the information and their understanding of the examination policies.
This document is an application for the Southern Luzon State University (SLSU) College Entrance Examination. It requests information from the applicant such as name, date of birth, contact details, high school attended, intended campus and course, and disability information. It also contains certification that the applicant has read the information bulletin, that all information provided is true and accurate, and that they will abide by test administration rules. The applicant must sign to confirm the information and their understanding of the examination policies.
This document is an application for the Southern Luzon State University (SLSU) College Entrance Examination. It requests information from the applicant such as name, date of birth, contact details, high school attended, intended campus and course, and disability information. It also contains certification that the applicant has read the information bulletin, that all information provided is true and accurate, and that they will abide by test administration rules. The applicant must sign to confirm the information and their understanding of the examination policies.
Southern Luzon State University ______________________ Date: __________________ GUIDANCE, COUNSELING & TESTING CENTER Control No. Lucban, Quezon
APPLICATION FOR COLLEGE ENTRANCE EXAMINATION
(To be filled up by SLSU Guidance Personnel) SLSU Main Campus SLSU Gumaca SLSU Polillo CBA Bldg. SLSU Infanta SLSU Tagkawayan SLSU Alabat Date of Exam: ________________________________ Time: _______________ SLSU Lucena SLSU Tiaong SLSU Catanauan
TO THE STUDENT AND PARENT/GUARDIAN
Read carefully the GENERAL INFORMATION BULLETIN ON FRESHMAN ADMISSION before filling out this application form. Print legibly all information required. Place X marks in appropriate boxes.
1. APPLICANT’S NAME:
Print or type your full name in the following sequence: LAST NAME, FIRST NAME, MIDDLE NAME. Place one letter in each box. Leave one box blank between names.
LAST
FIRST Staple or paste a recent 2” MIDDLE x 2” photograph with 2. SEX Male Female white background (taken within the last six months) 3. DATE OF BIRTH (Month, Day, Year) in this box. 4. PLACE OF BIRTH (City/Town, Province) Be sure to print your name 5. CIVIL STATUS Single Married Widow/Widower at the back of the photo.
8. HIGH SCHOOL (where you completed/are completing secondary level education):
High School Name (Do not Abbreviate) Month/Year of Completion
Address (City/Town, Province)
TYPE OF HIGH SCHOOL: Public Private-Sectarian Private - Non Sectarian
Others, Pls. Specify
9. SLSU CAMPUS APPLIED FOR: Choose from among the following, write your choice on the space below (up to two choices allowed) 1. SLSU Main 3. SLSU Catanauan 5. SLSU Infanta 7. SLSU Polillo 2. SLSU Alabat 4. SLSU Gumaca 6. SLSU Lucena Dual Tech 8. SLSU JGE-Tagkawayan 9. SLSU Tiaong
Do not indicate the same campus twice. Make sure that course choices are offered in the campus indicated. Write NONE on the blank if you do not have other choices of campus/course. Please see back page of the paper for the course code.
SLSU2Infanta Camp AA-INS-2.01F1, Revision 11. ARE YOU A CHILD OF SLSU FACULTY OR EMPLOYEE? NO YES IF YES Name of parent employed in SLSU Official Designation College/Unit where employed
A. Category B. Tenure C. Status (Place an X in only one box)
Full – time Permanent In active service Part – time Temporary On leave with pay Casual On leave without pay Contractual
12. Do you have any PHYSICAL DISABILITY OR CONDITION that requires special attention or would make it difficult for you to take a regular test
No Yes (specify) _____________________________________
to be filled up by SLSU Guidance Personnel FOR TRANSFEREES ONLY
HIGH SCHOOL GRADES COLLEGE/UNIVERSITY LAST ATTENDED:
FINAL GRADE 1st 2nd 3rd
ENGLISH MATH Reason for transfer: Approved: SCIENCE GEN. AVERAGE College Dean
I affirm that:
1) I have read all the information contained in the General Information Bulletin on Freshman Admission and understood all the instructions relative to my application for the SLSU Admission Exam; I certify that all information declared here are true and 2) All the information supplied in this application form are true, complete and accurate; 3) I have not taken the SLSU CEE previously correct 4) I will abide by the University rules and policies on test administration
I am aware that every information written in this application may be checked against the original documents and I understand that I will be allowed to take the examination upon submission of complete requirements. Signature over Printed Name of Parent/Guardian Furthermore, I understand that all information I provide in this form as well as during the Admission Exam may be used by the University for research and I believe that my personal details will be treated with utmost confidentiality. Date
O.R. No.___________________________________________________ Date _____________________________________________ Control No. ________________________________________________
APPLICATION RECEIPT SLSU CAMPUS COURSE CODE Staple or paste a recent (Please copy the correct course code) 2” x 2” photograph 1st Choice with white background 1st Choice (taken within the last 2nd Choice six months) in this box.
1st Choice Be sure to print your
2nd Choice name at the back of the 2nd Choice photo.
APPLICANT NAME ________________________________________________________________ GENDER _____________________________
DATE OF BIRTH ________________________________________________________________ PLACE OF BIRTH ______________________________
1. 2 (two) pcs. 2”x2” with white SLSU Testing Center: 2. Pencil 2pcs. (Mongol No. 2) background (recent photo) 3. Eraser SLSU Main Campus – Lucban Quezon 2. High School Form 137 SLSU Gumaca Guidance Office: 4. School ID CBA Bldg. (042) 540 – 4087 (Grades from 1st year to 3rd SLSU Lucena Loc. No. 135/ SLSU Alabat FAILURE OF APPEARANCE TO THE SLSU Polillo (042) 540 – 3949 year H.S.) (Clear Xerox SLSU Catanauan SPECIFIED DATE MEANS NO www.slsu.edu.ph Copy) SLSU Tagkawayan RECONSIDERATION FOR RE – SCHEDULING SLSU Infanta SLSU Tiaong 3. Examination Fee Php 150.00 LATE COMERS WILL NOT BE ENTERTAINED
