CG FORM 01 Applicant No: _________________

Application form for

USL COLLEGE ENTRANCE TEST (USL-CET)
For School Year 2019 – 2020
PERSONAL INFORMATION: (Type or PRINT clearly and completely)
Given Name

Middle Name

Last Name

Suffix (e.g. JR, II or III) Gender: Civil Status: Date of Birth: (yyyy/mm/dd)
Male ( )Female ( ) Single ( ) Married ( )
Mobile Number: ID NUMBER: (To be provided
(Please make sure that this is an active and available number) during registration)
Complete Home Address:

Term of Application: Please Check: New Student ( ) Transferee ( ) Second Course ( )

Please check if you have the following Disability for special accommodation in testing
( ) Physically Handicapped ( ) Hearing Impairment ( ) Visual Impairment
( ) Others, Pls. specify: ________________________

For applicant currently enrolled in Grade 12 this School Year 2018-2019

Name of School: Strand:

Complete School Address: Date of Graduation:

Please Check Three (3) Priority Course/Program to Apply for:

( ) Bachelor of Science in Accountancy (BSAc) ( ) Bachelor of Arts in Political Science (BAPOS)
( ) Bachelor of Science Management Accounting (BSMA) ( ) Bachelor of Science in Psychology (BSPSY)
( ) BSBA - Financial Management ( ) Bachelor in Medical Laboratory Science (BS Med Tech)
( ) BSBA - Marketing Management ( ) Bachelor of Science in Pharmacy (BS Pharm)
( ) Bachelor of Science in Tourism Management (BSTM) ( ) Bachelor of Science in Nursing (BSN)
( ) Bachelor of Science in Hospitality Management (BSHM) ( ) Bachelor of Science in Architecture (BSAr)
( ) Bachelor of Elementary Education (BEED) ( ) Bachelor of Science in Civil Engineering (BSCE)
( ) Bachelor of Secondary English Language Education (BSELE) ( ) Bachelor of Science in Computer Engineering (BSCpE)
( ) Bachelor of Secondary Filipino Language Education (BSFLE) ( ) Bachelor of Science in Electrical Engineering (BSEE)
( ) Bachelor of Secondary Mathematics Education (BSME) ( ) Bachelor of Science in Electronics Engineering (BSECE)
( ) Bachelor of Secondary Science Education (BSSE) ( ) Bachelor of Science in Geodetic Engineering (BSGE)
( ) Bachelor of Secondary Social Studies Education (BSSSE) ( ) Bachelor of Science in Computer Science (BSCS)
( ) Bachelor of Physical Education (BPED) ( ) Bachelor of Science in Information Technology (BSIT)
For applicant who graduated from Senior High in 2017 or earlier, please answer truthfully and accurately:
Have you already taken the USL-CET? ( ) Yes, on __________________________________ ( ) No
Have you ever enrolled in any college or vocational/technical course? ( ) Yes ( ) No
If yes: What School? ____________________________________________________________________
What Course(s)? ______________________________________________________________________
When? Semester/Summer Term: ________________________________________________________
The confirmation of your College Entrance Exam Schedule will be given through SMS or Text Message. Settle your Testing Fee at the
Window 2 of the Accounting Office of the University upon receiving the confirmation BEFORE YOUR EXAM DATE and proceed to the
College Guidance Center to SECURE/CLAIM your TEST PERMIT!
For Inquiries Contact us on the Following Lines: CP No. 09559051960/Land Line (078) 844 1822 loc: 402

UNDERTAKING (must be carefully read and accomplished by every filer):

I respectfully apply to take the USL-CET for SY 2019-2020 in accordance with the USL-CET. I declare that all the above
information is COMPLETE, ACCURATE and TRUE. I certify that, to date, I understand that any information I have misrepresented,
concealed, or falsely given on my application is enough basis to invalidate and cancel my application, my USL-CET result, my
admission/enrolment in USL, and the forfeiture of all payments made by me in favor of USL. I also promise to comply with all the
guidelines, requirements and instructions on the USL-CET and the admission requirements and special conditions.
By submitting this form, I consent and agree that the above information shall be used by the University for legitimate purposes
and shall be processed by authorized personnel in accordance with the Data Privacy Policies of the University.

_________________________________ _______________________________
Applicant’s Signature Date of Application
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Verified By: Guidance Counselors
The blank form may be reproduced or photocopied as needed, but NOT FOR SALE.