Date of Exam: Time:

1st CHOICE
2nd CHOICE
3rd CHOICE
1. APPLICANTS NAME
SURNAME
FIRST NAME
MIDDLE NAME NAME EXTENSION (e.g. Jr., Sr. )
2. AGE 10. COMPLETE HOME MAILING ADDRESS
3. DATE OF BIRTH (mm/dd/yyy)
4. PLACE OF BIRTH
5. GENDER 11. E-MAIL ADDRESS
6. CIVIL STATUS
7. CITIZENSHIP 12. TELEPHONE / CELLPHONE NO. (if any)
8. HEIGHT(ft)
9. WEIGHT (Kg)
13. NAME OF HIGH SCHOOL 14. YEAR GRADUATED
15. SCHOOL ADDRESS
16. TYPE OF HIGH SCHOOL ( Please check)
Public Private - Sectarian Private - Non-sectarian Others
12.COLLEGE/UNIVERSITY LAST ATTENDED:
FINAL GRADE
ENGLISH
MATH Reason for transfer:
SCIENCE
GEN. AVERAGE
DATE SIGNATURE OF APPLICANT
xxx ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- xxx
1st CHOICE
2nd CHOICE
3rd CHOICE
APPLICANT NAME
DATE OF BIRTH PLACE OF BIRTH GENDER
SIGNATURE: DATE
APPROVED:
APPLICATION RECEIPT
College Dean
INTENDED COURSE: (Pls. copy the correct course code, i.e. BSN, BSAcc., BSA, BSCpE)
(To be filled up by Guidance Personnel)
INTENDED COURSE: (Pls. copy the correct course code, i.e. BSN, BSAcc., BSA, BSCpE)
Pls. specify
1st Year 2nd Year 3rd Year
HIGH SCHOOL GRADES
FOR TRANSFEREES ONLY: to be filled up by SLSU Guidance Personnel
Republic of the Philippines
Southern Luzon State University
GUIDANCE & TESTING CENTER
Lucban, Quezon
APPLICATION FOR COLLEGE ENTRANCE EXAMINATION
( To be submitted together with H.S. Form 137)

O.R. No. _____________

Date: ________________
O.R. No. _____________

Date: ________________

__________________
Control No.

______________________
Control No.

SCHEDULE OF EXAM.
(To be filled up by guidance Personnel)

DATE: _________________________________ TIME: ____________
VENUE: Gomburza Bldg. 3rd Flr.
Hamlet Hall , Jose Rizal Bldg.4th Flr.
AVR , MHDel Pilar Bldg., 3rd Flr.

Bring the following on examination day:

1.Application receipt
2.Pencil ( Mongol No. 2 )
3.Eraser


1" X 1"
RECENT
ID PICTURE

1" X 1"
RECENT
ID PICTURE
REQUIREMENTS FOR ENTRANCE
EXAMINATION:
1.2 (two) pcs. 1X1 recent photo
2.High School Form 137(Grade from 1st
year to 3rd year H.S.) (Clear Xerox Copy)
3.Examination Fee Php 150.00

Guidance Office :
(042)540-3775 /
(042)540-4087
Loc. No.135
www.slsu.edu.ph
Gomburza Bldg. 3rd Flr.
Hamlet Hall, Jose Rizal Bldg.4th Flr.
AVR, MHDel Pilar Bldg.3rd Flr.