CHINESE GENERAL HOSPITAL COLLEGES

286 Blumentritt St., Sta. Cruz, Manila 1014

Trunk Line Number: (632) 711-41-41 Local 601 ● Telefax: (632) 711-00-75
Accounting Office: (632) 743-21-29 ● Registrar’s Office: (632) 743-89-41

APPLICATION FOR ENTRANCE EXAMINATION

Course Applied: (Please check)
□ Bachelor of Science in Nursing
□ Bachelor of Science in Medical Laboratory Science 2x2
(Bachelor of Science in Medical Technology) colored ID picture
□ Bachelor of Science in Radiologic Technology with white background
□ Bachelor of Science in Physical Therapy (wearing white polo
□ Bachelor of Science in Psychology with collar)
Temporary ID Number: ____________________________

Please check:

□ Senior High School Graduate: Track __________________ □ Transferee

PERSONAL INFORMATION
NAME:
_____________________________________________________________________
(Last Name) (First Name) (Middle Name)

HOME ADDRESS: _________________________________________________________

SEX: _____ AGE: ______ DATE OF BIRTH (mm/dd/yyyy): _____________________
LANDLINE NUMBER: (____ ) ______________ MOBILE PHONE:______________________

If Foreign National:
ACR No.:_____________ DATE ISSUED: _______________ PLACE ISSUED: ___________

EDUCATIONAL BACKGROUND
SENIOR HIGH SCHOOL: ____________________________________________________
SCHOOL ADDRESS: _______________________________________________________
MONTH AND YEAR GRADUATED/EXPECTED TO GRADUATE: ___________________________

(For Transferees Only)

COLLEGE: ______________________________________________________________
COURSE / DEGREE: _______________________________________________________
SCHOOL ADDRESS: _______________________________________________________
INCLUSIVE YEARS / YEAR GRADUATED: ________________________________________

To Be Filled Out By CGHC Guidance, Counseling and Testing Office:

Date Submitted: ____________________________________________________
Examination Schedule: (Date) __________ (Time) _________ Venue: ___________
O.R. Number: _________________ Date Paid: ____________________________
Application Form Received By: __________________________________________
Learned about CGHC through:
 School career fair/Brochures/Flyers
 Website/Facebook
 Relatives
 Friends
 Others (please specify): __________________________
General Application Requirements (Entrance Exam)
□ Accomplished application form
□ Photocopy of PSA Birth Certificate (Filipino or Dual Citizens); Authenticated Birth Certificate
(Foreign Students)
□ Three (3) pieces identical and recent 2x2 colored ID picture with white background (wearing
white polo with collar)
□ One (1) piece long plastic envelope
□ Two (2) pieces long brown envelope
□ Official receipt of payment for the entrance examination
Additional Requirements For:
A. Transferees
□ Certified True Copy of Grades/Scholastic Records/Transcript of Records
B. Foreign Students
□ Original and photocopy of study permit/student visa issued by the Bureau of Immigration
□ Photocopy of Alien Certificate of Registration (ACR) I-Card
□ Original and photocopy of IELTS Certificate/Certificate stating English was used as a medium
of instruction issued by school head from student’s country of origin
□ Certified True Copy of Grades/Scholastic Records/Transcript of Records or its equivalent
List of Requirements for INTERVIEW (passed entrance exam)
For SENIOR HIGH SCHOOL GRADUATES
□ Photocopy of Certification from the school stating that the applicant belongs to the present
graduating batch (if still enrolled) or Photocopy of Certificate of Graduation (if graduated) with
the specific track and strand taken
List of Requirements for ENROLMENT (passed interview screening)
For SENIOR HIGH SCHOOL GRADUATES
□ Original and photocopy of Senior High School Report Card (Form 138)
□ Original and photocopy of recent (dated on or after graduation) Certificate of Good Moral
Character
□ Original and Photocopy of Certificate of Graduation with the specific track and strand taken
□ Original PSA-authenticated Birth Certificate
□ Original and Photocopy of Medical Examination Clearance issued by the College Physician
□ HBsAG screening and/or anti-HBs titer test results
□ 1 piece 2x2 colored photo with white background (wearing white polo with collar)
□ Accomplished ID Application Form
For TRANSFEREES
□ Original Certificate of Transfer Credential
□ Original and photocopy of recent (dated on or after graduation) Certificate of Good Moral
Character
□ Original PSA-authenticated Birth Certificate
□ Original and Photocopy of Medical Examination Clearance issued by the College Physician
□ HBsAG screening and/or anti-HBs titer test results
□ 1 piece 2x2 colored photo with white background (wearing white polo with collar)
□ Accomplished ID Application Form
For FOREIGN STUDENTS
□ Same requirements for Senior High School Graduates or Transferees
□ All documents, except Medical Examination clearance issued by the College Physician, should
be authenticated by authorized heads from school/country of origin or legal residence

GCTO-AEE
Revised 9/2017