TARLAC STATE UNIVERSITY

ADMISSION AND REGISTRATION OFFICE

Tarlac City, Philippines

APPLICATION FORM FOR ADMISSION Paste one

(Graduate School, Professional Unit, Second Courser and Transferees) 2x2 picture taken

PLEASE PROVIDE THE CORRECT INFORMATION AND PRINT LEGIBLY within the last six months
Application No.: Student Number:
Application Type: School Year:
Course & Major: College:

PERSONAL INFORMATION

LAST NAME FIRST NAME MIDDLE NAME Jr./I/II/III

Date of Birth: - - Place of Birth:

Month Day Year
Gender: MALE FEMALE Civil Status: SINGLE MARRIED WIDOW/ER

Nationality: Contact Number:

Religion: Email Address:
Complete Residence Address:
Postal/Zipe Code:

FAMILY BACKGROUND
Father: Mother:
Occupation: Occupation:
Company: Company:
Company Address: Company Address:
Home Address: Home Address:
Contact Number: Contact Number:
IN CASE OF EMERGENCY:

Guardian: Company:
Relationship: Contact Person:
Address: Address:
Contact Number:
Email Addresss: Telephone no.:
Occupation: Mobile / Phone Number:

EDUCATIONAL BACKGROUND
COLLEGE MASTERAL / DOCTORAL
NAME OF SCHOOL: NAME OF SCHOOL:
ADDRESS: ADDRESS:
COURSE TITLE: COURSE TITLE:
INCLUSIVE DATES: INCLUSIVE DATES:

Director, Admission and Registration Office Date: ____________________

Sir/Madam
I have the honor to apply for enrollment in the College of _____________________ with the course ___________________ major in __________________
at the Tarlac State University, Tarlac City
For evaluation purposes, I am submitting herewith the following requirements:

Transfer Credentials Note:

Copy of Grades / Official Transcript of Records (Original) Refusal to take this pledge or violation of stated
Machine Copy of Authenticated PSA Birth Certificate terms and conditions shall be sufficient cause for
denial of admissions or non-acceptance in the
Machine Copy of Authenticated PSA Marriage Certificate (for female married students)
University.
2 pcs. 2x2 colored pictures (taken within the last six months)
Self-Stamped Mailing Envelope
Accomplished Application Form for Admission
TSU Psychological Test Result (Testing Center at the Student Affairs Building)

In consideration of my admission to Tarlac State University and all the privileges of students in this institution I hereby pledge to
abide and comply with all the rules and regulations set by competent authorities in this University. Furthermore, I bind myself with all
the present and future requirements of the curriculum I am enrolled in as prescribed by the Institution.

Very truly yours,

Signature over Printed Name of Applicant

Form No.: TSU-REG-SF-05 Revision No.: 01 Effectivity Date: February 10, 2020 Page 1 of 1