Republic of the Philippines

SORSOGON STATE COLLEGE

Sorsogon City, Sorsogon 4700
Telefax: 056-211-0200
Rev. www.sorsogonstatecollege.edu.ph
03
Aug. 1, 2019

ADMISSION TEST PERMIT

Tertiary Level
Period: First Semester A.Y. 2021-2022
Recent 2" x 2" colored ID picture
with white background

Applicant's Name: BON MARK JAPHET GUTIERREZ ___

None
Last Name First Name Middle Name Name Ext.
Address: PUROK 2 CAWIT EXTENSION , Magallanes, Sorsogon __

Preferred SSC Campus:[X] Sorsogon City [ ] Bulan [ ] Magallanes [ ] Castilla

Course Choices: BPED / BSFI / __

1st Choice 2nd Choice 3rd Choice Applicant's Signature

Application Number: ADS21-144806 ___ TEST SCHEDULE

Feb 8, 2021 3:00 PM SSC Magallanes Room 2
Date of Application: Jan 11, 2021 12:18 PM ___
Date & Time Venue Seat #
Examinee Number: MC21-100271 __ Reminders:
• Be at the testing center at least 15 minutes before the time.
Official Receipt: Date: ___
• Bring this Test Permit, rubber eraser, pencils (Mongol #2), sharpener and ballpen.
• Cheating, impersonation and other forms of examination irregularity can be a
Registered by: Sheena Marie D. Manere __ ground for disqualification for admission or dismissal, if admitted.

FM-ADS-002A Received by: Date: Jan 12, 2021 7:59 PM

Republic of the Philippines

SORSOGON STATE COLLEGE
Sorsogon City, Sorsogon 4700
Telefax: 056-211-0200
Rev. www.sorsogonstatecollege.edu.ph
03
Aug. 1, 2019

ADMISSION TEST PERMIT

Tertiary Level
Period: First Semester A.Y. 2021-2022
Recent 2" x 2" colored ID picture
with white background

Applicant's Name: BON MARK JAPHET GUTIERREZ ___

None
Last Name First Name Middle Name Name Ext.
Address: PUROK 2 CAWIT EXTENSION , Magallanes, Sorsogon __

Preferred SSC Campus:[X] Sorsogon City [ ] Bulan [ ] Magallanes [ ] Castilla

Course Choices: BPED / BSFI / __

1st Choice 2nd Choice 3rd Choice Applicant's Signature

Application Number: ADS21-144806 ___ TEST SCHEDULE

Feb 8, 2021 3:00 PM SSC Magallanes Room 2
Date of Application: Jan 11, 2021 12:18 PM ___
Date & Time Venue Seat #
Examinee Number: MC21-100271 __ Reminders:
• Be at the testing center at least 15 minutes before the time.
Official Receipt: Date: ___
• Bring this Test Permit, rubber eraser, pencils (Mongol #2), sharpener and ballpen.
• Cheating, impersonation and other forms of examination irregularity can be a
Registered by: Sheena Marie D. Manere __ ground for disqualification for admission or dismissal, if admitted.

FM-ADS-002A