Bicol Univeristy

OFFICE OF ADMISSIONS
Legazpi City
Staple/Paste
1pc.
PERSONAL INFORMATION SYSTEM
2x2 photo
BICOL UNIVERSITY COLLEGE ENTRANCE with nametag
SCORING SYSTEM (BUCESS)
SY 2021 - 2022
Application Form No.
Application & Testing Fee: P 250.00 (free)
o Students and Parents:
Reference Code:
ONLY FOR APPLICANTS WHO HAVE NOT ENROLLED IN ANY COURSE/ SUBJECT BEYOND SENIOR HIGH SCHOOL.
Date of Appointment:
EAD THE GENERAL INFORMATION FOR BUCET applicants and the contents of this form before filling in the information asked.
Time of Appointment:
ion is valid only for entrants during the school year indicated above.
NSWERS.
Permit No.
Verified by:
1. Intended Course. Print your Course Choice and CODE number on the box provided below. Please refer to the BUCET GENERAL INFORMATION
on College Freshmen Admission. Course indicated in this form are final. Changing of course is strictly not allowed.
COURSE CODE COURSE NAME CAMPUS

Course Choice

SHS Track

2. PRINT OR TYPE YOUR NAME IN THE FOLLOWING SEQUENCE: Last Name, First Name, Middle
Name.
Check one box only:
Last Name
3. SEX Male Female

First Name 4. CITIZENSHIP: Filipino

Non-Filipino
Middle Name
5. RELIGION:
6. PERMANENT HOME ADDRESS

Number and Street

Subd./Village, Brgy.

City/Town & Province ,

Postal/Zip Code
Email Address
Tel./Cell. Phone No.

7. Senior High School graduated or graduating from: Expected/date of graduation

School Address , Learner's Reference No.
8. Junior High School Completed from
School Address ,
9. Applicant's Date of Birth: 10. Civil Status (Check one box only)
Year Month Date Single Married Other (specify)
11. Applicant's Place of Birth:
12. Occupation of Father/Guardian: Occupation of Mother/Guardian:

13. Do you have any PHYSICAL DISABILITY or CONDITION that would make it difficult for you to take a regular test? No Yes
(Please attach Certification of Disability and Submit to the BUAO).
14. Monthly Family Income:

Less than P 10,999.00 (attach Certificate of Indigency) P 15,000.00 - P P 31,000.00 - P 49,999.00

20,999.00
P 11,000.00 - P 14,999.00 Exceeding P 50,000.00
15. Is your family a member of: P 21,000.00 - P
30,999.00

15.1 4 P's
Yes No 15.2 Indigenous People Yes No

I HEREBY CERTIFY ON MY HONOR THAT I HAVE UNDERSTOOD THE HEREIN INSTRUCTIONS AND THAT ALL THE INFORMATION HEREIN CONTAINED IS TRUE AN

Signature o

NOTE: Please submit

BU-F-ADMISSION- Not for Sale. Reproduction is allowed. Rev. 1

Effectivity date: January 11, 2021 Page 1 of 2
TO THE
PRINCIPAL: SECONDARY SCHOOL RECORD
This form is an official document to be used by the BU Admissions Office for selective admission and research purposes.
1. Please type or print legibly all information called for. Do not abbreviate
2. For the student's name, print last name, first name and middle name in full.
3. Be sure that all grades (i.e., including failing marks) are indicated and that all entries are complete and specific such as number of
units or credits earned for such subject on this page.
4. TAMPERING WILL INVALIDATE THIS APPLICATION FORM.

NAME OF STUDENT APPLICANT:

Last Name First Name Middle Name
Name of High School:
Nationalized High School Vocational - Tech Private Sectarian Private Non-Sectarian NGU
Sponsored

Address of High School:

District/Town City/Province
Track in Senior High School: ACADEMIC TECH-VOCATIONAL ARTS &
DESIGN
( ) ABM ( ) HUMSS ( ) GAS Area of Specialization: SPORTS
( ) STEM ( ) PRE-Baccalaureate Maritime
Year of Graduation: No. of Graduates/Expected Graduates:

GRADE 9 GRADE 10 GRADE 11

1st sem., 2nd sem.,
Basic/Core Subjects SY 20 to 20 SY 20 to 20 SY 20 to SY 20 SY 20 to SY 20
FinalGrades
Final Remarks FinalGrades
Final Remarks FinalGrades
Final Remarks FinalGrades
Final Remarks
○ FILIPINO Grades Grades Grades Grades
● Komunikasy on at Pananaliksik sa Wika at Kulturang Pilipino
● Pagbasa at Pagsusuri ng Iba't Ibang Teksto Tungo sa
○ ENGLISH
● Oral Communication in Context
● Reading & Writing Skills
● 21st Century Lit. from the Phil. & the World
○ MATHEMATICS
● General Mathematics
● Statistics & Probability
○ SCIENCE
● Earth / Life Science
● Physical Science
○ ARALING PANLIPUNAN
● Understanding Culture, Society & Politics
● Contemporary Phil. Arts from the Regions
● Introduction to the Philosophy of the Human Person
○ EDUKASYON SA PAGPAPAHALAGA
● Personal Development/Pansariling Kaunlaran
○ TECHNOLOGY & LIVELIHOOD EDUCATION
○ MAPEH
● Physical Education and Health
● Disaster Readiness & Risk Reduction
○ ICT / ● Media and Information Literacy
Other Basic/Core Subjects in JHS/SHS

● APPLIED & / SPECIALIZED SUBJECTS

● ADDITIONAL SUBJECTS

GENERAL WEIGHTED AVERAGE

(Please fill in the 4 boxes for year 9 to 11)

○ Subjects offered in Gr. 9 to 10

● Subjects offered in Gr. 11 This student belongs to the: Upper 10% Upper 20% Upper 40% Lower 50% of the

PRINCIPAL'S CERTIFICATION
I HEREBY CERTIFY AS TO THE COMPLETENESS AND CORRECTNESS OF THE FOREGOING RECORD AND FURTHER
ATTEST THAT.
(Fill-in applicant's name)

will be graduating in senior high school this school year 20- 20 has graduated in senior high school during the school year.
(check () appropriate box) Form 137-A requested by:

Name of School
Affix school dry seal here, if school has one. Principal's Signature (in ink)
(Facsimile not allowed)
Principal's Name (Print)_
Date
graduating class.