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CMucat Application Form PDF

This document is an application form for the Central Mindanao University College Admission and Scholarship Test (CMUCAT). It requests personal information from applicants such as name, birthplace, address, family details, educational background, intended course of study, and signature certifying the accuracy of the information provided. Upon approval, it issues a permit allowing applicants to take the CMUCAT on a specified date and time at a designated testing location.

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giselle lano
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
258 views

CMucat Application Form PDF

This document is an application form for the Central Mindanao University College Admission and Scholarship Test (CMUCAT). It requests personal information from applicants such as name, birthplace, address, family details, educational background, intended course of study, and signature certifying the accuracy of the information provided. Upon approval, it issues a permit allowing applicants to take the CMUCAT on a specified date and time at a designated testing location.

Uploaded by

giselle lano
Copyright
© © All Rights Reserved
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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