Reference No.: BatStateU-FO-TAO-08 Effectivity Date: October 11, 2021 Revision No.

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BATANGAS STATE UNIVERSITY

OFFICE OF THE STUDENT AFFAIRS AND SERVICES Attach a recent 2”x2”
Testing and Admission Office photograph (taken within
the last six months)
GRADES FORM 1
(Regular Admission)

To the applicant
Please forward this form to your School Registrar or Principal. The indicated grades in this form will be the basis for your admission
application in the University. Any misrepresentation, falsification, and any form of dishonesty shall result to non-admission to BatStateU.
Once accomplished, proceed to http://dione.batstate-u.edu.ph/tao/#/application to apply.

To the School Registrar or Principal

The applicant whose name appears in this form is applying for BatStateU College Admission Year ___2022__. We would like to
respectfully request for your assistance in filling out this BatStateU College Application Grades Form.
▪ Attach a Certificate of SHS Completion/ Enrolment
▪ Affix complete information of the SHS details at the lowest portion
▪ Provide a copy of the Form 137A.
▪ Countersign in any correction on any written information below.
▪ Only the School Registrar or Principal may certify the Grades form.
For clarifications, you may contact the Testing and Admission Office (TAO) - Central through 980-0385 local 1148 and tao@g.batstate-
u.edu.ph.

FULL NAME:

TRACK & STRAND:

SCHOOL NAME:

SCHOOL ADDRESS:

JHS COMPLETION YEAR: SHS COMPLETION YEAR:

JUNIOR HIGH SCHOOL SUBJECTS:

General Average General Average General Average
Grade 8
Mathematics Science English
Grade 9
Mathematics Science English
Grade 10
Mathematics Science English
SENIOR HIGH SCHOOL SUBJECTS:
• Priority Subjects
General Average General Average General Average

Grade 11, 1st Semester (STEM)

Pre-Calculus Earth Science/ Oral Communication
Earth and Life Science
Grade 11, 2nd Semester (STEM)
Basic Calculus General Chemistry I Reading & Writing
Grade 11, 1st Semester (NON-STEM)
General Mathematics Earth Science/ Oral Communication
Earth and Life Science
Grade 11, 2nd Semester (NON-STEM)
Statistic and Probability Physical Science Reading & Writing

• Alternative Subjects (In the absence of priority subjects)

General Average General Average General Average General Average General Average General Average
STEM
General Statistics and General Physics I General General Biology I English for
Mathematics Probability Chemistry II Academic Purposes
NON - STEM
Business Mathematics Disaster Readiness and Risk Reduction English for Academic Purposes

CERTIFIED TRUE AND CORRECT:

Senior High School (SHS):
School Registrar Principal
_____________________________ SHS Contact Information:
Signature over Printed Name of Email _________________________________
the School Registrar/ Principal Mobile Number: ________________________