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ADMISSION EXAM FORM

PRINT CLEARLY ALL INFORMATION IN THIS APPLICATION FORM.

Name:______________________________________________________________________ Mobile No.:______________________ Age:______


Sex:________
Home address: _____________________________________________________________________________________________ |
__________________________
(Street/Barangay) (Municipality/City) (Province) (Zip Code) (Email)
Date of Birth: ____________________

Senior High School Attended: __________________________________________________________________________| _____ Public ____ Private

Senior High School Address: ____________________________________________________________________________________________________

SHS Track: _____ STEM ____ABM ____HUMSS ____SPORTS ____TVL ____ARTS & DESIGN ____GAS

Preferred VSU Campus: (Check only one)


______ VSU Main (Baybay) ______ Alang-alang ______ Isabel ______ Tolosa ______ Villaba

Undergraduate Degree Programs (Please mark [/] preferred degree on the blank.)
(VSU-Main) (VSU - Alang-alang)
____ Bachelor of Arts (English Language) ___ Bachelor of Science in Environmental Management
____ Bachelor of Culture and Arts Education ___ Bachelor of Secondary Education
____ Bachelor of Early Childhood Education ___ Bachelor of Elementary Education
____ Bachelor of Elementary Education ___ Bachelor of Agricultural Technology
____ Bachelor of Science in Agribusiness ___ Diploma in Agricultural Technology
____ Bachelor of Science in Agricultural and Biosystems Engineering
(VSU - Isabel)
____ Bachelor of Science in Agriculture (*Agronomy
___ Bachelor of Secondary Education
*Agricultural Economics *Agricultural Botany *Agricultural Extension ___ Bachelor of Elementary Education
*Animal Science *Horticulture *Plant Breeding *Plant Protection ___ Bachelor of Science in Information Technology
*Soil Science) ___ Bachelor of Science in Industrial Engineering
____ Bachelor of Science in Agricultural Chemistry ___ Bachelor of Science in Agribusiness
____ Bachelor of Science in Biology (*Botany *Ecology *Marine Biology) ___ Bachelor of Science in Mechanical Engineering
____ Bachelor of Science in Biotechnology ___ Diploma in Associate in Computer-Technology (ACT)
____ Bachelor of Science in Civil Engineering ___ Diploma in Trade Technical Education (TTE)
____ Bachelor of Science in Chemistry
____ Bachelor of Science in Computer Science (VSU - Tolosa)
____ Bachelor of Science in Development Communication ___ Bachelor of Science in Fisheries
____ Bachelor of Science in Development Education ___ Bachelor of Secondary Education
____ Bachelor of Science in Economics ___ Bachelor of Elementary Education
____ Bachelor of Science in Environmental Management ___ Bachelor of Science in Criminology
____ Bachelor of Science in Environmental Science ___ Bachelor of Science in Biology
____ Bachelor of Science in Exercise and Sports Science
(VSU - Villaba)
____ Bachelor of Science in Food Technology
___ Bachelor of Science in Agriculture
____ Bachelor of Science in Forestry ___ Bachelor of Agricultural Technology
____ Bachelor of Science in Geodetic Engineering ___ Bachelor of Elementary Education
____ Bachelor of Science in Hotel Management ___ Bachelor of Secondary Education
____ Bachelor of Science in Marine Biology
____ Bachelor of Science in Mechanical Engineering
____ Bachelor of Science in Nursing
____ Bachelor of Science in Statistics
____ Bachelor of Science in Tourism Management
____ Bachelor of Secondary Education
____ Bachelor of Physical Education
____ Doctor of Veterinary Medicine

I HEREBY CERTIFY that all information provided herein are true and correct to the best of my knowledge.

_____________________________________ Date: _______________


Signature over Printed Name

Requirements Checklist:

1. Application Form
2. School Identification Card or any valid ID with photo (ex. Driver’s License, Voter’s ID, Passport)
3. High School Card (if graduated), Certification of Grades and GPA for 3 rd Grading Period or 2nd Grading Period for
schools which opened in August issued by the Principal (if continuing Grade 12 student)

EXAMINATION PERMIT

This is to certify that ______________________________________________ of_____________________________________________


School, _____________________________________________________(Address) has complied with all the requirements for the VSU Admission
Test and is hereby issued this test permit.

_____________________________________________ ____________________________
Name & Signature of the Testing Coordinator Signature of the Examiner