APPLICATION FOR ADMISSION (GRADUATE)

Instructions: Please fill 2 copies out this form NEATLY and CLEARLY and accomplish and submit these 2 copies together with the
other admission requirements.

Graduate Degree Program Applied For:

_______________________________________________________________

For the A.Y. ______________________________ Recent 2x2

[ ] Summer [ ] 1st Semester [ ] 2nd Semester ID picture

Scholarship Status:
[ ] Paying
[ ] Scholarship (Please specify):_________________
[ ] Other financial support (Please specify)

PERSONAL INFORMATION
First Name: Middle Name: Last Name: Extension (Ex. Jr.)

Age: Gender: Date of Birth: Place of Birth: Nickname:

[ ] Male [ ] Female
Civil Status: Citizenship Ethnic Origin: Contact No:
[ ] Single [ ] Married [ ] Widow Mobile:
Landline:
Blood Type: Religion: Address in Butuan City: (if not from Butuan City)

Complete Home Address: Zip Code:

Email address: Person (w/ address and contact no.) to be contacted in case of emergency:

Height (feet): Weight (kilograms):

ENROLLMENT AND OTHER APPLICATIONS

Have you ever enrolled for graduate studies? [ ] Yes [ ] No If yes, when?
For what program
In what school?
of study?
Have you ever applied for graduate studies at the Caraga State University before? [ ] Yes [ ] No

If yes, when? For what program of study?

EDUCATIONAL BACKGROUND
Year of
Type of
Name of School Graduation Awards Received
School
(if graduated)
[ ] Private
Elementary:
[ ] Public
[ ] Private
High School:
[ ] Public
College:
[ ] Private
Degree: [ ] Public

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 APPLICATION FOR ADMISSION (GRADUATE)

EDUCATIONAL BACKGROUND
Master’s Studies:
[ ] Private
Degree: [ ] Public

Doctoral Studies:
[ ] Private
Degree: [ ] Public

Page 1 of 3
PROFESSIONAL EXPERIENCE
(from latest employment, use separate sheet if necessary)
Position Company/Agency Inclusive dates

REFERENCES
(List two previous professors in major subjects who can assess your ability to pursue graduate studies)
Name Position, Institution, Contact No., Email Address

PERSONAL ESSAY
(The essay should be 1-2 pages long, typewritten (or handwritten), double-spaced, printed on a long bond paper and signed
and attach it to this application form)
Please write a personal essay that covers the following:
a. Reasons for pursuing graduate studies at this time
b. Reasons for choosing your program of study
c. Personal qualities, abilities or special skills which you feel will help you do well in your chosen program of
study
d. Constraints or difficulties you anticipate to encounter while taking graduate studies
e. Potential contribution of a Caraga State University graduate education to your profession and the larger
society

I declare that the information supplied in this application and the documentation supporting it is true and
complete. I acknowledge that the provision of incorrect information and/or documentation in relation to my
application may result in cancellation of admission or enrolment. If admitted, I agree to abide by the policies,
rules and regulations of the Caraga State University Graduate School.

APPLICANT'S SIGNATURE:________________________________________DATE:__________________

Important:
Please attach the other admission requirements to this application form:

[ ] Two copies of Transcript of Records

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 APPLICATION FOR ADMISSION (GRADUATE)
Note: Authenticated Copy for CarSU
[ ] Certificate of Honorable Dismissal ( original & 1 photocopy)
[ ] Four pcs 2x2 ID pictures (attach one to the Application for Admission) [ ] Two pcs long brown envelope
[ ] Exam Result (from Admissions & Testing Center) [ ] Personal Essay
[ ] Medical Certificate
[ ] Student Personal record (c/o Graduate School Office) [ ] NSO Birth Certificate
[ ] Recommendations by former professors (GS Form 2013-002) [ ] Permit to Study

Place the Entrance Exam Result, the one copy of TOR, the original Honorable Dismissal, two pieces of ID pictures, and NSO Birth
Certificate in one envelope (Registrar's copy) and the rest in the other envelope (Graduate School's copy).
EVALUATION OF CREDENTIALS Page 2 of 3
Name of Applicant:

Graduate Program Applied For:

For the Graduate School/Major department only. Do not write beyond this line/page
RECOMMENDATION
Initial Evaluation by Graduate School Evaluated by:

[ ] Approved Status: [ ] Regular [ ] Probationary [ ] Non- _______________________________

degree Graduate School Dean

_______________
[ ] Disapproved Justification in case of downgrade Date

Reason(s):___________________________________________________
Evaluation by Major Department Evaluated by:

[ ] Approved Status: [ ] Regular [ ] Probationary [ ] Non-

degree ______________________________
Graduate Program Coordinator

[ ] Disapproved Justification in case of downgrade _______________

Date
Reason(s):___________________________________________________

Final Status of Application: [ ] Approved [ ] Regular [ ] Probationary [ ] Non-Credit

[ ] Disapproved

APPROVED BY:

_____________________________
Dean, Graduate School
Date:

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 APPLICATION FOR ADMISSION (GRADUATE)

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