Stupent A pmission Form LLEGE OF SCIENCE AND TECHNOLOGY Poe TG, uae INSTRUCTION: PLEASE PRINT ALL INFORMATION IN CAPITAL LETTERS AND USE BLUE INK ONLY. PERSONAL INFORMATION ‘MARK APPROPRIATE FIELDS WITH V AND “N/A” IF NOT APPLICABLE. LASTNAME: FIRSTNAME: 15" x 15" MIDDLENAME: ID Picture NAME EXTENSION: DATE OF BIRTH (mm/dd/yy) PLACE OF BIRTH: SEX CITIZENSHIP: iy COwate OFeMate ‘ADDRESS: CIVIL STATUS CONTACT NUMBER: EMAIL ADDRESS: Osinete o9| | | le JMARRIED Q CONTACT PERSON INCASE OF EMERGENCY: Quipoweo NAME: CONTACT NUMBER C)separaTED \_____________________ 9g| | }. Cotiers, sec RELATIONSHIP: SPORTS: TALENT: Bee EINeXei ie) NAME OF LAST SCHOOL ATTENDED: SCHOOL YEAR: AVERAGE: [Check ths if you are a Senior High Schoo! Graduate ACADEMIC HONORS: Senior High School Track ACADEMIC STRAND TECHNICAL-VOCATIONAL STRAND Oss OsFA Ooxumecnnes {erect eaten iar tihey ats) DP Onna romero STEM scan tnonarysinenaisy CE eccnuns) P Omarecunons” Qiennncrmema Course Taken from your OjUMss OF Onrovormesevicns — Ouermceasmummnaencen: Previous School? inion Soc Scenes Himasvethts) P Ocmeenemnceeme Qasr sec yABM icT Ocoururenrrocianans. ORM a raenedtiogmet Oi tramertcmriatostcen) > Soma COomners, COostuers,PRESENT EDUCATIONAL INFORMATION COURSE: (-)BACHELOR OF SCIENCE IN INFORMATION TECHNOOGY (BSIT) major in Web and Mobile Applications Development CO BACHELOR OF SCIENCE IN COMPUTER SCIENCE (BSCS) © BACHELOR OF SCIENCE IN INFORMATION SYSTEMS (BSIS) oO BACHELOR OF SCIENCE IN FOOD TECHNOLOGY (BSFT) NstP: (©cwrs Orore Ous STUDENT PLEDGE As an applicant for admission to Guimaras State University this term, | hereby promise to abide by the rules and regulations of the school now in force, as well as the rules and regulations that may be promulgated by the school from time to time, be loyal to the vision and mission of the school and fulfill my obligations whether financial or academic requirements. If violate any of the school rules and/or standards | am fully aware and shall bind myself to whatever disciplinary action the school may impose upon me. Conforme: Student's Signature FOR ENROLLING TEACHER'S USE CURRICULUM: DATE OF ADMISSION: a wnumeer: [JH ILH RESULT OF ENTRANCE EXAM/ REMARKS: STATUS UPON ADMISSION : O REGULAR O IRREGULAR RANSFEREE JQUITTERS O FOREIGNER “ENROLLING TEACHER/ DATE: