GAO RF-1

No.___________________
APPLICATION FOR ADMISSION

INSTRUCTIONS
1. Read the instructions carefully.
2. Fill out this form in PRINT (black ink).
3. Requirements for MQC Entrance Examination:
* Application Form, Pencil, 1 I.D Photo (2x2), Examination Permit
4. Submit fully accomplished form and bring the above-mentioned requirements to the Guidance and Admissions Office.

COURSE APPLIED FOR:

First Choice: Second Choice: Third Choice:

PERSONAL INFORMATION
NAME
Last First: Middle:

CONTACT DETAILS
Address:
Contact Number/s: E-mail Address: Gender:
Religion: Civil Status: Citizenship:
Birthdate: Place of Birth:
Entry Status: __ Freshman student __ Transfer Student __ Second Degree __ MQCCI Trainee

FAMILY BACKGROUND
FATHER
Name: Educational Attainment: Contact #:
Address: Occupation: Age: Monthly Income: Employer & Address:

MOTHER
Name: Educational Attainment: Contact #:
Address: Occupation: Age: Monthly Income: Employer & Address:

GUARDIAN
Name: Educational Attainment: Contact #:
Address: Occupation: Age: Monthly Income: Employer & Address:

IF MARRIED
Name of husband/wife: Educational Attainment: Contact #:
Address: Occupation: Age: Monthly Income: Employer & Address:

Parents are: __ Living Together __ Father/Mother Working Abroad __ Separated __ Father/ Mother Deceased __ Other situation _______________

MQC EXAMINATION PERMIT

Name: School: Course:

You are scheduled to take the MQC ENTRANCE EXAMINATION on

Please proceed to the Guidance and Admissions Office for the Examination Room assignment.
Reminders:
1. BRING THE FOLLOWING. MQC Application Form, Recommendation Form Pencil, 1 (2x2) I.D photo.
2. Examinee/s who cannot come on the scheduled examination date must notify the Guidance and Admissions Office.

Guidance Staff
 Siblings (in order) Age School Address

Relatives Now Enrolled/ Graduate OF Mary the Queen College (Pampanga)

Name Relationship Course Year Graduated

ACADEMIC INFORMATION
Elementary: Address: Type of School Year Graduated
_ Private _ Public
Secondary: Address: Type of School Year Graduated
_ Private _ Public
Tertiary: __ Transfer Applicant __ Second Degree Address Course Year Graduated

School:
Honors/ Awards:
Special Skills/ Talents:

OTHER INFORMATION
Relative Working at the House of David Group: Other Persons Supporting Studies:

Name Other School/s Where You Applied or intend to apply:

How did you first know about MQC?
(Please check appropriate answer)
Why did you choose to apply at MQC?
(Please check appropriate answer)
_ Parents _ Relatives _ Friends _ MQC Student _ Alumni
_ TV _ Print Advertisement _ MQC Marketing (Career Orientation)
_ High School Counselor/ Teacher/ Principal
_ Parents'/ Relatives' Influence _ Quality Education _ School Facilities
_ Discipline _ Security _ Well-known College _ Highly Qualified Teachers
_ Courteous Staff _ Accessibility & Location _ Low Tuition Fee
_ Clean Campus __ Others (pls. specify) ____________________________

HEALTH STATUS
General Condition of Health: Commmon Health Complaints:

I certify the information given herein are correct and complete. Falsification of information on this form will
automatically nulify my application and/ or subject me to dismissal from the college.

Applicant's Signature over Printed Name