Form No.

: IFD-COP-GDCT001-002
Revision No.: 01
BOHOL ISLAND STATE UNIVERSITY Effectivity Date: November 11, 2019
Candijay Campus
Cogtong, Candijay, Bohol Related Process: BISU-COP-GDCT-001
APPLICATION FOR ENTRANCE
EXAMINATION

LRN:_____________________________________
Course Applied: ___________________Date Applied: ______________________
Name: __________________________________________________________________________________ 2x2 Picture
Sex: __________________ Age: __________________ Status:_______________ (Not a cut out.)

Date of Birth: ___________________________________________________________________________

Place of Birth: _________________________________________________________________________
Home Address: __________________________________________________________________________________________________________
Contact Number: _____________________________________ Email Address: _________________________________________________
Name of Father: ______________________________________ Name of Mother: _______________________________________________
Address of Parents: _____________________________________________________________________________________________________
Last School Attended: ___________________________________________________________________________________________________
School Address: _________________________________________________________________________________________________________
General Average: ___________________________________ Date Graduated: _________________________________________________
Honors Received: _______________________________________________________________________________________________________

Reason/s for Enrolling in BISU: (Please check the corresponding boxes of your answer.)
 1. My parents want me to study here.
 2. It is known for its high passing percentage in Licensure Examinations (LET and Engineering, etc.)
 3. My friends & relatives are studying here.
 4. For convenience sake because we are living near the campus site.
 5. It provides quality education at affordable cost.
 6. I want to learn a trade.
 7. I am on a scholarship grant.
 8. I enrolled just for the sake of enrolling.
 9. Others
____________________________________________________________________________________

________________________________________________
Signature over Printed Name of Applicant

This form together with the required documents will be submitted to the screening committee on the testing
day.