Republic of the Philippines

Mindanao State University

Fatima, General Santos City
OFFICE OF ADMISSIONS

APPLICATION FOR ADMISSION

( OFAD Form No. 1, s.2018)

INSTRUCTION: Print all entries clearly and legibly.

Name: MAYO, DANGELA MAE PEREZ
(Family Name) (First Name) (Middle Name)

Date of Birth: March 19, 2004 Sex: Female Civil Status: Single Citizenship: Filipino

Religion: Roman Catholic Tribe: Tagalog Place of Birth: General Santos City Email: dangelamaeperezmayo@gmail.com
Present Address: Purok Masunurin , Barangay San Isidro, General Santos City
Home Address: Purok Masunurin, Barangay San Isidro, General Santos City Mobile number: 09388909159/ 09187214726
Last School Attended: General Santos City National Secondary School of Arts and Trades
Father's Name: Danilito Tumangday Mayo Tribe: Ilocano Occupation: Barangay Lupon Messenger Annual Income: ₱2,500.00
Mother's Name: Angela Tolentino Perez Tribe: Tagalog Occupation: Housewife Annual Income: None
Address: Purok Masunurin , Barangay San Isidro, General Santos City
MSU SASE Result: AP: 11 LU: 42 MA: 18 SC: 12 GR: 83 Strand: Arts & Design Date Taken: March 6, 2022

Person to be notified in case of emergency:

Mayo, Angela Perez

(Name)

Mother 09187214726 Purok Masunurin , Barangay San Isidro, General Santos City DANGELA MAE PEREZ MAYO
(Relationship) (Contact Number) (Address)
(Student's Signature)

(TO BE FILLED UP BY THE ADMISSION OFFICE PERSONNEL)

Admitted as: FRESHMEN ( ) TRANSFEREE ( ) SECOND DEGREE ( ) UNITING ( ) RETURNEE ( )
SEMESTER AND ACADEMIC YEAR ADMITTED: First semester, Academic Year: 2022 - 2023
Admitted in: BSEd Major in Filipino COLLEGE OF EDUCATION - SECONDARY EDUCATION
(Course/Major) (College)

Academic Status upon Admission: Credentials

submitted:

MSU SASE/CET ResultPhotocopy of Birth Certificate (PSA Copy)

Form 138/HS CardOMA Certification (if Muslim)
Good Moral CertificateNCIP Certification (if Tribal)
Transcript of RecordEmployee Dependent Certification
Honorable Dismissal

Documents Complete Not Complete Checked By: _____________ Infirmary: _____________

RECOMMENDED BY:
REMARKS: Guidance Office:
(Academic Adviser, Print Name & Sign)
Approved BY: PROF. JERRY J. DELA CRUZ Date:

STUDENT'S PLEDGE

In consideration of my admission to the MINDANAO STATE UNIVERSITY and of the privileges of the student of this institution, I hereby promise
and pledge to abide by and comply with all rules and regulation laid down by competent authority in the University in which I am enrolled.

(Student's Signature)
Date of Enrollment:
Mindanao State University
Guidance Office GUIDANCE
INFORMATION SHEET
First semester, Academic Year 2022 - 2023

Name: MAYO, DANGELA MAE PEREZ Course & Major: BSEd Major in Filipino SASE Score: 83

BirthDate: March 19, 2004 Sex: Female Age: 18 Religion: Roman Catholic Tribe: Tagalog
Civil Status: Single Contact number: 09388909159/09187214726
Home Address: Purok Masunurin, Barangay San Isidro, General Santos City
Present Address: Purok Masunurin, Barangay San Isidro, General Santos City
Honors received:_______________________ Scholarship:____________________ Other Scholarship:______________
School Last Attended: General Santos City National Secondary School of Arts and Trades
Date of Graduation: June 28, 2022
Course choice: BSEd Major in Filipino (1st choice) BS IT (2nd choice) ABE L

Family Background:

Name Age Tribe Educational attainment Occupation

Father: Danilito Tumangday 55 Ilocano College Graduate Barangay Lupon

Mayo
Messenger
Mother: Angela Perez Mayo 37 Tagalog High School Graduate Housewife
Number of Brothers: None

Number of Sisters: 4
Are your parents living together? / Yes No. if no, why?___________________________

How much is your family monthly income? Kindly check the box on the left:

Below P1,000 P3,000 - P5,000 P7,000 - P9,000 P11,000 - P13,000

/ P1,001 - P3,000 P5,001 - P7,000 P9,001 - P11,000 P13,001 - P15,000

Above P15,001

What are your skills?: Passionately dedicated to work and always willing to help in any circumstances. Always actively responds on
different activities that may requires creativity, patience, and hard work. Independently and socially cooperative and responsible at all
times.

Signature DANGELA MAE PEREZ MAYO Verified by:______________________________