Republic of the Philippines

Bicol University
OFFICE OF ADMISSIONS
Legazpi City

Application Form No. _______

APPLICATION FORM
for Transferee
PHOTO
International Student 2x2
(Recent)
 Carefully read the General Information before filling in the information asked. 2pcs.
(PRINT ALL THE ANSWERS)
 Please attach the following:
o Letter of Intent
o A recommendation from the School Head (last school attended) Application fee: $ 50.00
o TOEFL/IELTS Results via telegraphic transfer/bank
o Authenticated copy of the Official Transcript of Records remittance payable to:
(with the official grading system and its English translation, bearing the
original signature of the Registrar and School seal) Account name: Bicol University
o Photocopy of bank payment Bank name: Land Bank of the
Philippines
1. Intended Course. Print the course title and the campus you intend to enroll on the Account No.: 0134-0064-80
space provided below. Tel. No.: (052)480-0498

Intended Course Campus

Check one box only:
2. NAME: __________________________________________________
Last First Middle 3. Sex: [ ] Male [ ] Female
4. Citizenship: ________________
7. Date of Birth: _______________________________________________
Year Month Date 5. Religion: ___________________
6. Civil Status: [ ] Single
8. PERMANENT HOME ADDRESS
[ ] Married
________________________________________________________________________________________________
Street City or Town Province

Zip Code: ____________ Telephone/ Mobile Number: __________________________

Year
Name & Address of School Degree Program Term
Attended

I hereby certify on my honor that I have understood the herein instructions and that all the information
herein contained is true and correct.

Signature of Applicant Signature of Parent/Guardian

Over Printed Name Over Printed Name

AF Received by: ______________ Date Received: _______________

OTR/Certificate of Registration evaluated by: ____________________________

Do not write anything here. For Admissions Office use only.

ENDORSEMENT TO
TRANSFER

Name: ________________________________ __ Course Applied for: ________________ Unit/College: __________

Grade Point Average (GPA): _______ Required GPA: _______ Status: [ ] Qualified Decision Required: ( ) Yes
Academic Petitions Committee: _____________________ [ ] Disqualified ( ) No

Remarks: ________________________________________________________________
________________________________________________________________
______________________
Dean of Admissions
BU-F-ADMISSION-25
Effectivity Date: June 29, 2015 Rev. 0