Republic of the Philippines 

CENTRAL MINDANAO UNIVERSITY 
University Town, Musuan, Bukidnon 
 
OFFICE OF ADMISSIONS, SCHOLARSHIPS AND PLACEMENT (OASP)
 
 
 

PERSONAL DATA SHEET 

 
1​ST 
Semester/Summer 2018  to 20 19 
 
 
Student’s Name​:        
  Last Name  First Name  Middle Name 
 
Date of Birth:      Place of Birth:     
    MM    DD    YYYY      Municipality/City  Province 
 
Sex:   Civil Status:    If Married Woman, Maiden Name:       
          Last Name  First Name  Middle Name 
 
Ethnic Group:    Citizenship:    Religion:   
 
Blood Type:   Height (cm):    Weight (kg):    Number of Siblings:     
            Brother  Sister 
 
Mobile Number:  Email Address:  urib1724@gmail.com  Facebook Account:   
 
Home Address:           
  Street/Purok  Barangay  Municipality/City  Province  ZIP Code 
 
Father’s Name:       
  Last Name  First Name  Middle Name 
 
Mobile Number:  Email Address:  Educational Attainment:   
 
Occupation:   Company Name:    G-Annual Income (Php):  
 
Company Address:         
  Street/Purok  Barangay  Municipality/City  Province 
 
Mother’s Maiden Name:       
  Last Name  First Name  Middle Name 
 
Mobile Number:  Email Address:  Educational Attainment:   
 
Occupation:   Company Name:    G-Annual Income (Php):  
 
Company Address:         
  Street/Purok  Barangay  Municipality/City  Province 
 
Guardian’s Name:       
  Last Name  First Name  Middle Name 
 
Relationship:    Mobile Number:  Email Address:   
 
Educational Attainment:    Occupation:   Company Name:  
 
Company Address:         
  Street/Purok  Barangay  Municipality/City  Province 
 
Residence Information: 
 
Residence Location:  Residence Status:  Residence Type:  
 
Address:         
  Residence Name/ Boarding House/ Dormitory  Street/Purok  Barangay  Municipality/City 
 
Name​ (Owner/Caretaker/Manager)​:       
  Last Name  First Name  Middle Name 
 
Mobile Number:  Email Address:    Relationship ​(Owner/Caretaker/Manager)​: 
 
Admission Information: 
 
Admission Status:    Student’s ID Number: 
 
Course:    Year Level: 

I hereby certify under the pain of perjury that all my statements above are true and correct to the best of my knowledge. I consent that the Office of 
Admissions, Scholarships and Placement (OASP) may utilize my information in the submission of documents to CHED, UNIFAST and other government 
agencies. I understand that these information will not be used for any other purposes.  
 
 
______________________________________________________ 
Student’s Signature Over Printed Name