Professional Documents
Culture Documents
OFFICE OF ADMISSIONS
Legazpi City
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 MAROLLANO
3. SEX ✓ Male Female
First Name KENNETH
4. CITIZENSHIP:
✓ Filipino
Non-Filipino
Middle Name ADOLFO
5. RELIGION: ROMAN CATHOLIC
6. PERMANENT HOME ADDRESS
7. Senior High School graduated or graduating from: DARAGA NATIONAL HIGH SCHOOL Expected/date of graduation 2020
School Address DARAGA , ALBAY Learner's Reference No. 111691070038
8. Junior High School Completed from LACAG NATIONAL HIGH SCHOOL
School Address DARAGA, ALBAY
9. Applicant's Date of Birth: 2001 NOVEMBER 5 10. Civil Status (Check one box only)
Year Month Date ✓ Single Married Other (specify)
11. Applicant's Place of Birth: LACAG,DARAGA,ALBAY
13. Do you have any PHYSICAL DISABILITY or CONDITION that would make it di cult for you to take a regular test? ✓ No Yes
(Please attach Certi cation of Disability and Submit to the BUAO).
14. Monthly Family Income:
Less than P 10,999.00 (attach Certi cate of Indigency) ✓ P 15,000.00 - P 20,000.00 P 31,000.00 - P 49,000.00
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.
NOTE: Please submit P 45.00 worth of stamps and (1) long window envelope, for mailing your BUCET Result.