Republic of the Philippines

CAMARINES SUR POLYTECHNIC COLLEGES

Nabua, Camarines Sur
CSPC-F-STA-01

STUDENT TESTING AND ADMISSION OFFICE

APPLICATION FOR
CAMARINES SUR POLYTECHNIC COLLEGES COLLEGE ENTRANCE TEST
(CSPC-CET)

DATA SUBJECT ACKNOWLEDGEMENT AND INFORMED CONSENT:

“I hereby allow CSPC and its authorized personnel to collect and process the relevant data provided by me
and consent to the confidentiality bound performance of legitimate guidance functions such as counseling, admission
of the students, reporting, referrals, data security and compliance to legal requirements. I also have been aware of my
data privacy rights to be informed, to object, to access, to rectification, to erasure/blocking, and the damages and
impact of such rights towards psychological care. Further, I hereby declare that all the foregoing information provided
by me is true and correct and that I shall abide by the policy guidelines governing admission in CSPC. I further certify
that if any of the information indicated herein is not true and incorrect, my application for admission in Camarines Sur
Polytechnic Colleges will be null and void and that CSPC is not in any way responsible for the misrepresentations I
have declared.”


SIGNATURE OVER PRINTED NAME

---------------------------------------------------------------------------------------------------------------------------------------------------

 SHS (Track/Strand: )  Transferee  2-year course Graduate

 HS Graduate (Year: )  ALS Graduate  Re-ad  TESDA/Vocational Course
Passpo
rt size
PREFFERED CAMPUS:  Nabua/Main Campus  Buhi Campus picture
Control Number: GENERAL WEIGHTED AVERAGE:

NAME: (fill out your name in the box provided) DATE OF FILING: - -
LAST NAME:

FIRST NAME:

MIDDLE NAME:

SEX:  MALE  FEMALE CITIZENSHIP:  RELIGION:  CONTACT NUMBER:

DATE OF BIRTH:  AGE:  PLACE OF BIRTH:

(mm/dd/yyyy)
E-MAIL ADDRESS: 
NAME OF MOTHER:  OCCUPATION: CONTACT NUMBER: 
NAME OF FATHER:  OCCUPATION: CONTACT NUMBER:
MONTHLY FAMILY INCOME: 
PERMANENT ADDRESS:
LAST SCHOOL ATTENDED:
ADDRESS: 

HONORS/AWARDS RECEIVED: 
TALENTS AND SKILLS: 
COMMUNITY INVOLVEMENT/S:
ORGANIZATION/S:

1. What College or University

 is your first
is presently choice?
applying Second?
for admission in CSPC for school year  . Third?
In this regard, may we
2. Inforcase
ask youryou do not to
assistance qualify
fill upfor
theadmission, where do you
necessary information planintoassessing
needed pursue the
college? (Enumerate)
student. Thank you very much. God bless!
3. Course applied in CSPC: 1st Priority  2nd Priority  3rd Priority 
4. Reasons why you want to study in CSPC?

6. Do you have any other financial assistance? Specify 

7. Do you belong to a household that is or was a beneficiary of 4Ps? 

Effectivity Date: September Re Page 1 of

 Republic of the Philippines
CAMARINES SUR POLYTECHNIC COLLEGES
Nabua, Camarines Sur
CSPC-F-STA-01

REQUIREMENTS:
For Grade 12 graduating students:
 Duly accomplished Application Form (CSPC-F-STA-01);
 One (1) pc. of original passport size picture in blue background
 Photocopy of Form 137 (Grade 11) with GWA
 Scanned softcopy of the Application Form (CSPC-F-STA-01) saved as PDF and send
to testingandadmission@cspc.edu.ph
 File name: (Last Name, First Name, Middle name)
For Transferees:
 Duly accomplished Application Form (CSPC-F-STA-01);
 One (1) pc. of original passport size picture in blue background
 Photocopy of Transcript of Records (TOR) with GWA
 Scanned softcopy of the Application Form (CSPC-F-STA-01) saved as PDF and send
to testingandadmission@cspc.edu.ph
 File name: (Last Name, First Name, Middle
name) For TESDA/Vocational Course and ALS:
 Duly accomplished Application Form (CSPC-F-STA-01);
 One (1) pc. of original passport size picture in blue background
 Photocopy of Report Card
 Scanned softcopy of the Application Form (CSPC-F-STA-01) saved as PDF and send
to testingandadmission@cspc.edu.ph
 File name: (Last Name, First Name, Middle name)
For Re-admission students:
 Duly accomplished Application Form (CSPC-F-STA-01);
 Duly accomplished Re-admission form
 One (1) pc. of original passport size picture in blue background
 Photocopy of most recent grades
 Scanned softcopy of the Application Form (CSPC-F-STA-01) saved as PDF and send
to testingandadmission@cspc.edu.ph
 File name: (Last Name, First Name, Middle name)

COURSES OFFERED:
CSPC Nabua Campus
CSPC Buhi Extension Campus
 BS in Nursing (BSN)  BS in Office Administration (BSOA)
 BS in Midwifery (BSM)
 BS in Information Technology (BSIT)
 BS in Information Technology (BSIT)
 BS in Tourism Management (BSTM)
 BS in Information Systems (BSIS)
 BS in Entrepreneurship (BS Entrep)
 BS in Computer Science (BSCS)
 Bachelor in Library & Information Science (BLIS)
 BS in Electronics Engineering (BSECE) GRADUATE SCHOOL PROGRAMS
 BS in Civil Engineering (BSCE)
 BS in Electrical Engineering (BSEE) Master’s Degree Programs
 BS in Mechanical Engineering (BSME)  Master of Arts in Nursing (MAN)
 BS in Hospitality Management (BSHM)  Master in Engineering (ME)
 BS in Office Administration (BSOA)  Master in Business Management (MBM)
 BS in Entrepreneurship (BS Entrep)
 BS in Tourism Management (BSTM) Soon to offer
 BS in Mathematics (BS Math)
 BS in Applied Mathematics (BS Applied Math)  Master in Information Technology (MIT)
 BS in Development Communication (BSDevCom)  Master of Arts in Nursing Major in Disaster
 AB in English Language (AB Eng) Resilience (MANDR)
 Bachelor in Public Administration (BS PublicAd)  Master in Hospitality Management (MHM)
 Bachelor in Human Services (HumServ)
 Bachelor of Special Needs (BSNEd) Doctorate Degree Programs
 Bachelor of Physical Education (BPEd)  Doctor of Philosophy in Business
 Bachelor in Culture and Arts Education (BCAEd) Management (DBM)
 Bachelor in Technical Vocational Teacher Education (BTVTEd)
o Major in: Soon to offer
 Food Service Management
 Electronics Technology  Doctor of Philosophy in Nursing (PhD in
 Fish Processing Nursing)
SOON TO OFFER  Doctor in Information Technology (DIT)
 BS in Architecture
 BS in Computer Engineering
 BS in Entertainment and Multimedia Computing
 BS in Public Health
 BS in Emergency Medical Services
 BS in Nutrition and Dietetics
 BS in Social Work
 BS in Environmental Management
 BS in Business Administration Major in Financial Management

Effectivity Date: September Re Page 2 of