BUKIDNON STATE UNIVERSITY

Malaybalay City, Bukidnon 8700

Tel (088) 813-5661 to 5663; TeleFax (088) 813-2717, www.buksu.edu.ph

APPLICATION FOR COLLEGE ADMISSION TEST

RR

Examinee Number: BUKSU-QUEZ-00015

Examination Date: 04/20/2021 Time : 9:00 AM Room : QUEZON NHS- RM 1
PASTE
LRN: 126741080022
2x2
ID Picture Last Name: ARNEJO
(White background) Given Name: JEANY BABES
Middle Name: CURBO
Suffix:
Sex at Birth: FEMALE
Birthdate: 02/25/2003
Citizenship: Filipino
Civil Status: Single
Do you belong to any Indigenous Group? if YES Please write your Tribe
Tribe: N/A
Disability:

Region: NORTHERN MINDANAO 10 Province: BUKIDNON

Town/City/Municipality: Quezon Zip Code: 8715
Barangay: Salawagan Street/Purok: Demokrasya
Contact Number: 9055862911 Email Address: jeanybabesarnejo@gmail.com

DSWD Household Number/4P’s Number: 101317030176000000

Educational Status: Senior High Graduate

Campus Preference: BUKSU MAIN CAMPUS

Course Preference: BACHELOR OF SCIENCE IN DEVELOPMENT COMMUNICATION

Name of School: Salawagan National High School

Address of School:
01/11/2021 5:42:45 PM

Purok Mabuhay, Salawagan, Quezon, Bukidnon

I hereby agree and consent that the Bukidnon State University may collect, use, disclose, and/or process my/our personal information
entered in this BukSU - CAT online form, and/or otherwise as provided by me/us or processed by Bukidnon State University in the
implementation of its functions.

Jeany Babes Arnejo

Signature over printed Name

Document Code: Revision No. : Issue No. Issue Date: ELIMARC G. ELLORIN
ATO-F-001 00 1 February 8, 2021 Admission Personnel

BUKSU – COLLEGE ADMISSION TEST PERMIT

01/11/2021 5:42:45 PM

Name: ARNEJO, JEANY BABES

PASTE Sex at Birth: FEMALE
2x2
Examinee No. : BUKSU-QUEZ-00015 Examination Date: 04/20/2021
ID Picture
Time: 9:00:00 AM Room: QUEZON NHS- RM 1
(White background)
Reminders: Bring this slip together with a good pencil on your examination schedule. Be at the venue 1 hour
before your examination time.
Thank you for choosing Bukidnon State University!

Document Code: Revision No. : Issue No. Issue Date: ELIMARC G. ELLORIN
ATO-F-001 00 1 February 8, 2021 Admission Personnel