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Republic of the Philippines

Laguna State Polytechnic University

Province Of Laguna

ADMISSION AND TESTING SERVICES
APPLICATION FOR COLLEGE ENTRANCE TEST

Instructions: READ ADMISSION AND APPLICATION REQUIREMENTS AT THE BACK PAGE

Fill in all the required. information . DO NOT leave an item blank. if item is not applicable, indicate "N/A"

STATUS OF APPLICANT

Freshmen

Transferee

Returnee

Shifter

Continuer

PERSONAL INFORMATION

*Ext

*First Name

*Last Name

*Middle Name

*Date of Birth
(dd/mm/yyyy)

*Age(in years)

*Citizenship

*Gender

Male

Female

*CIVIL STATUS

Single

Married

Others

* Mobile No

(Country)

(Number)

Phone No

*INTENDED COURSE

* E-mail ADDRESS

*HEIGHT

*WEIGHT

Permanent Address

* House Number

Street

* Barangay

Town/Municipality /City

* Province

* Zip Code

Father's Name

*Last Name

Given Name

* Middle Name

Mother's Name

*Last Name

Given Name

* Middle Name

Guardian's Name

Last Name

Given Name

Middle Name

Telephone Number

Mobile Number

Address

Intended Course

Track/Strand (SHS)

1st option

2nd option

EDUCATIONAL ATTAINMENT

*ELEMENTARY

* School Address

*Type of School

Public

Private

*Year Attended

*High School

* School Address

*Type of School

Public

Private

*Year Attended

*Senior High School

* School Address

*Type of School

Public

Private

*Year Attended

*College ( for Transferees)

* School Address

*Type of School

Public

Private

*Year Attended

*Reason for Transfer

* DSWD HouseHold Number

*HouseHold Per Capita Income

*Disability

Communication Disability

Disability due to Chronic Illness

Learning Disability

Intelecctual Disability

Orthopedic Disability

Mental/Psychosocial Disabilty Visual Disabilty

None

Laguna State Polytechnic University

Province Of Laguna

ADMISSION AND TESTING SERVICES APPLICATION FOR COLLEGE ENTRANCE TEST

STATUS OF APPLICANT

PERSONAL INFORMATION

Permanent Address

Father's Name

Mother's Name

Guardian's Name

Intended Course

EDUCATIONAL ATTAINMENT

ADMISSION AND TESTING SERVICES
APPLICATION FOR COLLEGE ENTRANCE TEST