Bicol University

OFFICE
BicolOF ADMISSIONS
University
Legazpi
OFFICE OF City
ADMISSIONS
Legazpi City
Staple/Paste
APPLICATION
APPLICATIONFORM
FORM 2Staple/Paste
pcs.
BICOL
BICOL UNIVERSITYCOLLEGE
UNIVERSITY COLLEGEENTRANCE
ENTRANCETEST
TEST 2x2 photo
2 pcs.
(recent)
2x2 photo
(BUCET)
(BUCET) (recent)
SY 20___ - 20___
SY 20__ - 20__

Instructions to Students and Parents: Application Form No._________

THIS FORM IS ONLY FOR APPLICANTS WHO HAVE NOT ENROLLED IN ANY COURSE/ Appl. & Testing Fee: P 150.00
SUBJECT BEYOND SENIOR HIGH SCHOOL. O.R./M.O. No. ______________
CAREFULLY READ THE GENERAL INFORMATION FOR BUCET applicants and the contents Date Paid: _________________
of this form before filling in the information asked. Recorded by: _______________
ONLY CORRECTLY and COMPLETELY FILLED OUT FORMS will be issued a TEST PERMIT. Permit No. _________________
This application is valid only for entrants during the school year indicated above. GPA __________E+ _________
PRINT ALL ANSWERS.
1. Intended Course. Print your Course Choice and CODE number on the box provided below. Please refer to the BUCET GENERAL INFORMATION on
College Freshmen Admission. Course indicated in this form are final. Changing of course is strictly not allowed.

COURSE CHOICE COURSE CODE

__________________
2. PRINT OR TYPE YOUR NAME IN THE FOLLOWING SEQUENCE: Last Name, First Name, Middle Name. Place one letter in each box.
Check one box only:
Last Name
3. SEX Male Female
First Name 4. CITIZENSHIP: Filipino
Filipino
Non-Filipino
Non-Filipino
Middle Name
6. PERMANENT HOME ADDRESS 5. RELIGION: _________________

Number and Street

Subd./Village, Brgy.

City/Town & Province

Postal/Zip
Postal/Zip Code
Code

Tel./Cell. Phone No.

7. Senior High School graduated or graduating from: _________________________________________ Expected/date of graduation _____________
School Address ________________________________________________________
8. Junior High School Completed from ____________________________________________________
School Address ________________________________________________________
9. Applicant’s Date of Birth: ________________________________10. Civil Status (Check one box only)
Year Month Date Single Married Other (specify) _________________
11. Applicant’s Place of Birth: __________________________________________________________________________________________
12. Who will spend for your college education? My Parents
My Parents Others (specify) ______________________________________________
13. Occupation of Father/Guardian: ________________________________________ 14. Number of children in the family: ______________
Occupation of Mother/Guardian: ______________________________________
15. Do you have any PHYSICAL DISABILITY or CONDITION that would make it difficult for you to take a regular test? No Yes
(Please attach Certification of Disability and Submit to the BUAO).
16. Monthly Family Income:
Less than P 10,000.00 P 15,000.00 - P 20,000.00 P 31,000.00 - P 49,000.00
P 11,000.00 - P 14,000.00 P 21,000.00 - P 30,000.00 Exceeding P 50,000.00
17. What award in sports/arts have you received? __________________________________

APPLICANT’S CERTIFICATION
I HEREBY CERTIFY ON MY HONOR THAT I HAVE UNDERSTOOD THE HEREIN INSTRUCTIONS AND THAT ALL THE
INFORMATION HEREIN CONTAINED IS TRUE AND CORRECT. FURTHER, I ATTEST THAT I HAVE NOT ENROLLED IN ANY
COURSE / SUBJECT BEYOND SENIOR HIGH SCHOOL, OTHERWISE MY APPLICATION FOR ENTRANCE IN BICOL UNIVERSITY
WILL BE RENDERED INVALID.

_________________________________________ ________________________________________
Signature of Applicant Signature of Parent/Guardian over Printed Name

NOTE: Please submit P 45.00 worth of stamps and (1) long window envelope, for mailing your BUCET Result.

BU-F-ADMISSION-29 Rev. 0
Effectivity date: July 17, 2017 Page 1 of 2