Bicol Univeristy

OFFICE OF ADMISSIONS
Legazpi City
Staple/Paste
APPLICATION FORM 2pcs.
BICOL UNIVERSITY COLLEGE ENTRANCE TEST 2x2 photo
(BUCET) (recent)
SY 2019 - 2020

Instructions to Students and Parents: Application Form No. ____________

THIS FORM IS ONLY FOR APPLICANTS WHO HAVE NOT ENROLLED IN ANY COURSE/ Application & Testing Fee: P 250.00 (free)
SUBJECT BEYOND SENIOR HIGH SCHOOL. Reference Code:
CAREFULLY READ THE GENERAL INFORMATION FOR BUCET applicants and the contents Queue Date:
of this form before filling in the information asked. Queue Time:
ONLY CORRECTLY AND COMPLETELY FILLED OUT FORMS will be issued a TEST PERMIT. Permit No. _____________________
This application is valid only for entrants during the school year indicated above.
PRINT ALL ANSWERS. GPA _____________E+__________

1. Intended Course. Print your Course Choice and CODE number on the box provided below. Please refer to the BUCET GENERAL INFORMATION
on College Freshmen Admission. Course indicated in this form are final. Changing of course is strictly not allowed.
COURSE CODE COURSE NAME CAMPUS

1st Choice

2nd Choice

2. PRINT OR TYPE YOUR NAME IN THE FOLLOWING SEQUENCE: Last Name, First Name, Middle Name. Place one letter in each box.
Check one box only:
Last Name
3. SEX Male Female
First Name 4. CITIZENSHIP: Filipino

Non-Filipino
Middle Name
5. RELIGION:
6. PERMANENT HOME ADDRESS

Number and Street

Subd./Village, Brgy.

City/Town & Province

Postal/Zip Code 4 Email Address vaneh

Tel./Cell. Phone No.

7. Senior High School graduated or graduating from: Expected/date of graduation

School Address
8. Junior High School Completed from
School Address
9. Applicant's Date of Birth: 10. Civil Status (Check one box only)
Year Month Date Single Married Other (specify)
11. Applicant's Place of Birth:
12. Occupation of Father/Guardian: Occupation of Mother/Guardian:

13. Do you have any PHYSICAL DISABILITY or CONDITION that would make it difficult for you to take a regular test? No Yes
(Please attach Certification of Disability).
14. Monthly Family Income:

Less than P 10,999.00 (attach Certificate of Indigency) P 15,000.00 - P 20,000.00 P 31,000.00 - P 49,000.00

P 11,000.00 - P 14,000.00 P 21,000.00 - P 30,000.00 Exceeding P 50,000.00

15. Is your family a member of:

15.1 4 P's Yes No 15.2 Indigenous People Yes No

APPLICANT'S CERTIFICATION

I HEREBY CERTIFY ON MY HONOR THAT I HAVE UNDERSTOOD THE HEREIN INSTRUCTIONS AND THAT ALL THE INFORMATION
HEREIN CONTAINED IS TRUE AND CORRECT. FURTHER, I ATTEST THAT I HAVE NOT ENROLLED IN ANY COLLEGE COURSE/SUBJECT
BEYOND SENIOR HIGH SCHOOL, OTHERWISE MY APPLICATION FOR ENTRANCE IN BICOL UNIVERSITY WILL BE RENDERED INVALID.

Signature of Applicant Signature of Parent/Guardian over Printed Name

NOTE: Please submit P 45.00 worth of stamps and (1) long window envelope, for mailing your BUCET Result.

BU-F-ADMISSION-29 Not for Sale. Reproduction is allowed. Rev. 1

Effectivity date: July 17, 2018 Page 1 of 2