Carlos Hilado Memorial State College

Alijis Campus | Binalbagan Campus | Fortune Towne Campus | Talisay Campus

2x2 ID Picture
COLLEGE OF ARTS AND SCIENCES-GRADUATE STUDIES

INTERVIEW FORM

Documents needed for interview: Original & Certified Photocopy of Transcript of Records, Diploma and
Letter of Recommendation from Two Former Professors

NAME: ____________________ __________________ _______________ Age: ______ Sex: _________

(Last Name) (First Name) (Middle Name)
Civil Status: ___________ Height: ______ Weight: ______ Nationality: __________ Religion: _____________
Date of Birth: ____________________________ Place of Birth: ____________________________________
Permanent Address: _____________________________________________ Contact No.: ______________
Parents/Guardians: Father’s Name: _________________________________ Occupation: _____________
Mother’s Name: _________________________________ Occupation:_____________
Wife’s/Husband’s Name: ______________________Occupation: __________ CP Number: ______________
Email Add: _____________________________ Messenger Account:________________________
Schools last attended:
Name of High School Graduated From: _______________________________________________
School Address: _______________________________________________
Year Graduated: _______________________
College: _______________________________________________
School Address: _______________________________________________
Year Graduated: _______________________
Degree: _______________________________________________
Year Graduated: _______________________
Honors & Awards Received During:
Elementary: _______________________________________________
High School: _______________________________________________
College: _______________________________________________
Program to Enroll: _______________________________________________
Scholarships Enjoyed in College: _______________________________________________

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(For Interviewer’s use only)

Rating
INTERVIEWER’S
Criteria ABOVE SIGNATURE
POOR FAIR AVERAGE EXCELLENT
AVERAGE
Oral Communication Skills

Ability to Answer Questions

Remarks (To be accomplished by the Chairperson/Dean):

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________________________________________________________________________________________
________________________________________________________________________________________
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____________________________
Graduate Studies Chairperson

GS-TAL-F.03
REVISION 0
NOVEMBER 6, 2018