XAVIER UNIVERSITY - ATENEO DE CAGAYAN %Rank

ADMISSIONS OFFICE (CSAT/ATCU) OLSAT

TEL. No.:(08822)723116 (088)8583116 Local 2054, 2055, 2064
EMAIL: [email protected] WEBSITE: www.xu.edu.ph English:______ SAI: _____
APPLICATION FORM AFFIX
Math: ______ %Rank:_____
Please print this in a LONG SIZE BLUE PAPER RECENT Science:______ Stanine:_____
PHOTO IR: ______
Office Use
1x1 GSA: ______ (Do not fill up)

FRESHMEN ( ) TRANSFEREE ( ) CIT ( )

NAME:__________________________________________________________________
Last Name First Name Middle Name _____________________
SCHOOL LAST ATTENDED:_____________________________________________________ COURSE
SCHOOL ADDRESS:____________________________________________________________________ DATE ATTENDED:______________________

HOME ADDRESS:__________________________________________________________________________________________________________
# street Town/Barrio City Province Postal Code

CDOC ADDRESS:______________________________________________________________________ TELEPHONE NO.:(_____)_______________

DATE OF BIRTH:_________________CIVIL STATUS:________________ RELIGION:_______________________ AGE:________________________

CITIZENSHIP:___________________EMAIL: _____________________ LANGUAGE/S SPOKEN:______________ SEX:________________________

EDUCATIONAL BACKGROUND
List all grade schools, high schools and vocation/technical course attended

NAME OF SCHOOL INCLUSIVE DATES/YEARS DEGREE, HONORS, AWARD RECEIVED

PRIMARY:___________________________________________ ____________________ ________________________________________

ELEMENTARY:________________________________________ ____________________ ________________________________________

SECONDARY:________________________________________ ____________________ ________________________________________

VOCATIONAL/TECHNICAL COURSE:____________________ _________________ __________________________________

FAMILY BACKGROUND
FATHER’S NAME:________________________________________________________ AGE: ____________ OCCUPATION:___________________

WORKING WITH:________________________________________________________ COMPANY’S ADDRESS:______________________________

MOTHER’S NAME:________________________________________________________ AGE: _____________ OCCUPATION: __________________

WORKING WITH:________________________________________________________ COMPANY’S ADDRESS:______________________________

OR SPOUSE :___________________________________________________________ AGE: _____________ OCCUPATION: __________________

GUARDIAN’S NAME:______________________________________________________________ RELATIONSHIP:_____________________________

ADDRESS:______________________________________________________________________TEL. NO.:__________________________________

NUMBER OF SIBLINGS IN THE FAMILY:______________________ (name and their level of education from the eldest to the youngest)

NAME AGE LEVEL OF EDUCATION

1. _____________________________________________ ______________ ________________________________________

2.______________________________________________ ______________ ________________________________________

3.______________________________________________ ______________ ________________________________________

4.______________________________________________ ______________ ________________________________________

5.______________________________________________ ______________ ________________________________________

FOR TRANSFEREE ONLY FOR RETURNEE ONLY

LIST ALL UNIVERSITIES AND/OR COLLEGES YOU HAVE ATTENDED HAVE YOU TRANSFERRED/ATTENDED ANY UNIVERSITY OR COLLEGE
AND INCLUSIVE DATES. PLEASE ARRANGE TO HAVE OFFICIAL WHILE YOU STOP SCHOOLING IN XU?… YES … NO IF “YES” PLEASE
TRANSCRIPT SENT TO THE UNIVERSITY REGISTRAR’S OFFICE OF ARRANGE TO HAVE OFFICIAL TRANSCRIPT SENT TO THE UNIVERSITY
XU-ATENEO. (Failure to disclose previous attendance at another institution REGISTRAR’S OFFICE OF XU-ATENEO. LIST ALL UNIVERSITIES AND/
could result in academic dismissal) OR COLLEGES YOU HAVE ATTENDED AND INCLUSIVE DATES.
SCHOOL INCLUSIVE DATES SCHOOL INCLUSIVE DATES
__________________________ __________________ _____________________________________________
_____________________________________________
__________________________ __________________ _____________________________________________

__________________________ __________________ LAST SY ENROLLED WITH XU ?____________________________

NO. OF SEMESTER YOU HAVE STOPPED ?___________________
SEMESTER COURSE:____________________________________
REASON(S) WHY QUIT SCHOOL ?
FOR FOREIGN STUDENT ONLY _____________________________________________
z

FOR WHICH YEAR OF STUDY?____________________________ z_____________________________________________

_____________________________________________
z

FROM WHAT COUNTRY? ________________________________

PLEASE ANSWER THE FOLLOWING QUESTIONS:

WHAT WERE THE IMPORTANT FACTORS IN YOUR DECISION TO APPLY TO XU-ATENEO?

1._________________________________________________________________________________________________
2._________________________________________________________________________________________________
3._________________________________________________________________________________________________

WHO WERE THE PEOPLE WHO INFLUENCED YOU MOST TO CHOOSE XU-ATENEO?
1._________________________________________________________________________________________________
2._________________________________________________________________________________________________
3._________________________________________________________________________________________________

YOUR INTEREST/HOBBIES_____________________________________________________________________________________
__________________________________________________________________________________________________

ATTESTATION
I hereby agree to abide by all the rules and regulations which _______________________________________
apply to students of XU-Ateneo and acknowledge that my right Name & Signature of Father
to remain AT XU-Ateneo is subject to my observance of them.
The information in this application is complete and correct to
the best of my knowledge. I acknowledge that XU-Ateneo is
required to abide by the Freedom of Information and Protection _______________________________________
of Privacy legislation as it applies to universities. Name & Signature of Mother

______________________________________ _______________________________________
Student Signature Name & Signature of Guardian
(if applicable)
________________________________
Date

C O L L E G E C O U R S E S
COLLEGE OF ARTS & SCIENCES
BACHELOR OF ARTS IN:
Economics Philosophy History Filipino Sociology International Studies English Language & Literature
BACHELOR OF SCIENCE IN:
Biology Chemistry Mathematics Marine Biology Psychology
SCHOOL OF BUSINESS AND MANAGEMENT
B A C H E L O R O F S C I E N C E I N A C C O U N TA N C Y
BACHELOR OF SCIENCE IN BUSINESS ADMINISTRATION MAJOR IN:
Business Economics, Marketing Management, Financial Management
COLLEGE OF AGRICULTURE
BACHELOR OF SCIENCE IN AGRICULTURE MAJOR IN:
Crop Science, Animal Science, Agricultural Economics
BACHELOR OF SCIENCE in :
Agribusiness Agricultural Engineering Food Technology
BACHELOR OF SCIENCE IN DEVELOPMENT COMMUNICATION MAJOR IN:
Development Journalism, Educational Communication
SCHOOL OF EDUCATION
BACHELOR OF ELEMENTARY EDUCATION SPECIALIZATION IN:
General Education, Special Education, Pre-School Education
BACHELOR OF SECONDARY EDUCATION MAJOR IN:
English, Filipino, Mathematics, Biological Sciences
PROFESSIONAL EDUCATION (For non-education graduates)
DIPLOMA OF SPECIAL EDUCATION TEACHING PROGRAM
COLLEGE OF NURSING
BACHELOR OF SCIENCE IN NURSING
COLLEGE OF ENGINEERING
BACHELOR OF SCIENCE in:
Civil Engineering Chemical Engineering Electrical Engineering Mechanical Engineering
Electronics Engineering Industrial Engineering
BACHELOR OF SCIENCE IN COMPUTER SCIENCE MAJOR IN:
Information Technology, Software Engineering, Network Engineering
CENTER FOR INDUSTRIAL TECHNOLOGY - XU CIT
(3 YEAR TECHNOLOGY COURSES)
ELECTRONICS TECHNOLOGY with Certificate in:
1st Yr. (PC Operation NC II), 2nd Yr. Consumer Elex NC II), 3rd Yr. (Consumer Elex NC IV)
COMPUTER TECHNOLOGY SPECIALIZATION ON CALL CENTER with Certificate in:
1st Yr (PC Operation NC I ), 2nd Yr (Computer Hardware Servicing)
MECHANICAL TECHNOLOGY MAJOR IN METAL WORKING with Certificate in:
1st Yr (Machining NC 1), 2nd Yr (Machining NC II), 3rd Yr (Machining III)
MECHANICAL TECHNOLOGY MAJOR IN AUTOMOTIVE with Certificate in:
1st Yr (Automotive Servicing NC II), 2nd Yr (Automotive Servicing NC III),
3rd Yr (Automotive Servicing NC IV)