Republic of the Philippines CEBU TECHNOLOGICAL UNIVERSITY Main Campus Student Affairs Office GUIDANCE OFFICE - DAY PROGRAM APPLICATION FORM FOR ENTRANCE TEST | agree to provide 2 complete and accurate information asked herein and allow the University to process it for any legal Purpose. Wrthnolding or giving false information wil make me ineligible for admission or subject to dismissal from the university. If ‘admitted, | agree to abide by ine policies, rules and regulations of Cebu Technological Univers JOE ave s ESCALA May 02,2022 Signature over Printed Name of StudenAppicant Date Signed > a ‘Tracking Code: CTUIWdOaDm-01 Examinae Number: 22-03-0018603 BACHELOR OF SCIENCE IN MECHANICAL Application for ENGINEERING Hioay CJevening Program Major Application for: [] senior High School Graduate []Transteree []Shiter [-] Retumee (Jats Graguate [righ scnoot Graduate (ola cumculum ITSenlor High Schoo! Graduate: Track’Strang: BSIME - 119298080252 Learner's Reference Number (LRN) 1. Name ESCALA JOHN VADE SIACOR Family Name First Name Middle Name 2.Gender: MM Maic []Female 9.Age:__19__ 4. Date of Birth: August 17,2002 5. citizenship. FILIPINO 6.civi status: singe [Jared [-] Separates 6TH DISTRICT T.Home Address: CASILI SITIOBATO CONSOLATION CEBU __District_CONSOLACION. Zipcode __6001 Email caress: ejonnvade@gmattcom TelephoneNo: 9610849656 Mobile! Cell Phone No.: 9610840665 8, Secondary Education Complete Name of Last School Attended: UNIVERSITY OF CEBU BANILAD. Year Graduated: 2021 Address of Schoo: UNIVERSITY OF CEBU BANILAD. 9. College Education (Fortranstereas/Shitters/Returnees) Degree! Course: School: No. of Units Earned: Inclusive School-yearis: From To To be Filled-out by the college/department. Grade Point Average: 7 Screenedby: __sysiem generated _Date of Sereaning: May 02,2022 Endorsed for entrance test. Ronald M. Galindo Name and Signature of College Dean