Generated: November 14, 2023 - 08:34:03 pm

Submission Schedule - January 18, 2024 AM

Admission Information - 026882- 1st semester 2024-2025
Campus - CvSU-Main
Entry: New Type: Grade 12 student Applicant Type: Filipino
Strand: HUMSS
LRN:
Preferred Course:
BSC

Personal Information
Name: CASERES, JUSTIN MOJICA Sex: Male
Address: Sitio Bulsukan,Mataas Na Burol,Silang,CAVITE,4118
Email: justincaseres14@gmail.com Mobile#: 09086508066
Birthdate: 2006-06-14 Nationality: Filipino Civil Status: Single
PWD: No Indigenous: No
Family Background
Contact Occupation
Father: Daniel Caseres 09482876785 Farmer
Mother: Avelina Caseres 09482876785 House Wife
Guardian: Avelina Caseres 09482876785 House Wife
Family Income: Below 10,000 Number of siblings:1
Educational Background
Elementary
Muzon Elementary School Muzon Naic Cavite 2019 Public
High School
Maragondon Nation Highschool Maragondon Cavite 2022 Public
Senior High School
Emilia Ambalada Poblete Intergrated Highschool Silang Cavite 2024 Public
Vocational
Emilia Ambalada Poblete Intergrated Highschool Silang Cavite 2023 Public
Medical History Information
Medications: Brong Caustic To be filled up by the OSAS/Guidance Staff
Medical SUBMITTED REQUIREMENTS
Condition/s: __ Ordinary A4-size folder
I hereby acknowledge that all information stated above is true and New Student (Grade 12 student)
correct as to the best of my knowledge. I am submitting the correct __ Copy of accomplished application form for admission
and true document/s in compliance with the admission policy. Further, __ Photocopy of Grade 11 report card
I give consent for my personal data included in my offer to be __ Certificate from the Principal or Adviser indicating that the applicant
processed for the purposes of admission and enrolment in accordance is currently enrolled as Grade 12 student and the strand is also
with Republic Act 10173 - Data Privacy Act of 2012. indicated
Assessed by:___________________________
Control No.:026882

Signature over printed name

 Instruction on placing the control number stub in the folder CONTROL NO.

1. After you have printed your application form, kindly cut the control number 026882
stub that you see in the right portion of the form.
2. Paste the control number stub on the label corner of A-4 size folder using (cut the stub above)
glue.

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