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CMucat Application Form

This document is an application form for the Central Mindanao University College Admission and Scholarship Test (CMUCAT). [1] It requests personal information from applicants such as name, birthdate, address, family details, educational background, intended course of study, and high school grades. [2] Applicants must sign to certify the accuracy of the information provided and pay a 125 peso testing fee. [3] The form also includes a permit to be presented on the exam date with recent photo and signature of the applicant.

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Jiyan Litohon
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297 views1 page

CMucat Application Form

This document is an application form for the Central Mindanao University College Admission and Scholarship Test (CMUCAT). [1] It requests personal information from applicants such as name, birthdate, address, family details, educational background, intended course of study, and high school grades. [2] Applicants must sign to certify the accuracy of the information provided and pay a 125 peso testing fee. [3] The form also includes a permit to be presented on the exam date with recent photo and signature of the applicant.

Uploaded by

Jiyan Litohon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FORM 1X1

Or
Central Mindanao University COLLEGE ADMISSION & SCHOLARSHIP TEST (CMUCAT) 2X2
(Revised 2012)
Application No:_________ Recent Photo
Instruction: PRINT ALL ENTRIES IN THIS APPLICATION FORM
Testing Fee – Php 125.00 (BOR Res. No. 23 s. 2004)

A. APPLICANT
NAME: SEX: ( ) Male
, , . ( ) Female
(Family Name) (First Name) (M.I.)
BIRTH PLACE: BIRTH DATE: AGE: RELIGION: .
HOME ADDRESS: , ,
(Street No.) (Municipality) (Province/City)
SCHOOL ADDRESS:__________________________________________________________________

B. FAMILY
FATHER MOTHER
NAME
EDUCATIONAL ATTAINMENT
OCCUPATION
FAMILY ANNUAL GROSS INCOME
(In pesos)

C. EDUCATION
LEVEL NAME OF SCHOOL YEAR HONORS/ AWARDS
GRADUATED
ELEMENTARY
HIGHSCHOOL
OTHERS (If Transferee)

D. COURSE/S YOU INTEND TO TAKE AT CMU E. HIGH SCHOOL GRADE


CHOSEN COURSE/S ENGLISH
FIRST CHOICE SCIENCE
SECOND CHOICE MATH

`G. APPLICANT’S SIGNATURE H. ACTION TAKEN (To be filled up by the CMUCAT Board)

I hereby certify that the foregoing ( ) APPROVED ( ) DISAPPROVED ( ) PENDING


Information are true and correct.

___________________________________
___________________________________ CMUCAT BOARD
Signature of Student Date:_______________________________
Date:_________________________

NOTE: Subject to revocation if the records upon which the approval is based are found incorrect/invalid

CUT ALONG THIS LINE - - - - - - - - CUT ALONG THIS LINE - - - - - - - - - CUT ALONG THIS LINE - - - - - - - - -

CMUCAT PERMIT
1x1 Present this to the PROCTOR during the exam
Or
2x2
Recent Photo NAME OF EXAMINEE: ___________________________________________
DATE OF TEST : ________________________ TIME ______________
PLACE OF TEST:_________________________________________________

_______________________________
CMUCAT BOARD
Date filed ____________________
Signature: ________________________
Printed Name:_____________________

Note: 1. NO CMUCAT PERMIT: NO EXAM.


2. Wear your high school ID during the exam
3. Testing fee is non-refundable.

(REPRODUCTION OF THIS FORM IS ALLOWED BUT NOT FOR SALE)

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