Republic of the Philippines

CAMARINES SUR POLYTECHNIC COLLEGES

Nabua, Camarines Sur
CSPC-F-GUID-03
C E R T I F I C A T I O N

I HEREBY DECLARE THAT ALL THE FOREGOING INFORMATION PROVIDED BY ME ARE TRUE AND CORRECT AND THAT I SHALL ABIDE
BY THE POLICY GUIDELINES GOVERNING ADMISSION IN CSPC.
I FURTHER CERTIFY THAT IF ANY OF THE INFORMATION INDICATED HEREIN IS NOT TRUE AND CORRECT MY APPLICATION FOR
ADMISSION CAMARINES SUR POLYTECHNIC COLLEGES WILL BE NULL AND VOID AND THAT CSPC IS NOT IN ANYWAY RESPONSIBLE FOR MY
MISREPRESENTATIONS I HAVE DECLARED.


Signature of Applicant Signature of Parent/Guardian over Printed Name

.



Guidance Center

APPLICATION FOR
CAMARINES SUR POLYTECHNIC COLLEGES COLLEGE ENTRANCE TEST
(CSPC-CET for Transferee and HS Graduate Only)

To Students and Parents:
This form is only for applicants to CAMARINES SUR POLYTECHNIC COLLEGES ENTRANCE TEST (CSPC-CET).
For High School Graduates and Transferees only.
Carefully read the general information for CSPC-CET and answer all the details being asked as honestly as possible.
ONLY CORRECT AND COMPLETELY FILLED UP FORMS will be issued an Admit to CSPC-CET Permit. PRINT ALL ENTRIES.
1. Reason/s for leaving your school
2. What College or University do you plan to pursue your studies? 1
st
Choice 2
nd
3
rd

3. In case you did not qualify for admission, where do you plan to pursue your studies?(enumerate)
4. Course applied in CSPC: 1
st
Priority 2
nd
Priority Preferred Campus:
5. Reasons why you want to study in CSPC?

6. Who will spend for your College Education?
7. Are you applying for a Scholarship Grant? Specify
8. NAME:

Last Name:

First Name:

Middle Name:


9. SEX: Male CITIZENSHIP: Filipino Religion:
Female Others:

10. DATE OF BIRTH : PLACE OF BIRTH:
AGE :

11. PERMANENT HOME ADDRESS:
Number and Street:

Subdivision/Brgy:

City/Town and Province:

Zip Code

Contact number:
12. NAME OF PREVIOUS SCHOOL: ___________________________________________Course and Year:

ADDRESS: _______________________________________________________ SY last attended:
13. HONORS / AWARDS RECEIVED: _________
14. TALENTS AND SKILLS: _________
15. COMMUNITY INVOLVEMENT/S: ________
16. ORGANIZATION/S: ___________
17. PARENTS' OCCUPATION: Father: __________ Mother:
18. MONTHLY FAMILY INCOME:
PHP. Less than 5, 000.00 PHP. 20, 00.00 24,000.00
PHP. 10, 00.00 14,000.00 PHP. 25, 00.00 29,000.00
PHP. 15, 00.00 19,000.00 PHP. 30, 00.00 and above










( This application form is not for sale! This application form is not for sale!)


Examinee Number:
Testing Fee: PHP. 50. 00
O.R. Number:
Recorded by:
GPA:





1.5 x 1.5 Colored
Picture (Your most
recent Picture).
Computer generated
picture is not
accepted

























Effectivity Date: November 2013 Rev.1 Page: 1 of 2
Republic of the Philippines
CAMARINES SUR POLYTECHNIC COLLEGES
Nabua, Camarines Sur
CSPC-F-GUID-03
BS in Food Service Management (BSFSM)
BS in Office Administration (BSOA)
BS in Computer Science (BSComScie)
Computer Technician (CT)
Electronics Communication & Service Technology (ECST)
Bachelor in Technical Teacher Education (BTTE)

C E R T I F I C A T I O N

WE HEREBY CERTIFY AS TO THE COMPLETENESS AND CORRECTNESS OF THE FOREGOING RECORD AND THAT ANY ERASURE OR
ALTERATION MADE IN THE ACADEMIC RECORDS ABOVE RENDERS THE WHOLE ACADEMIC RECORDS INVALID.
APPEARING HERE IS THE SCHOOL DRY SEAL.



Signature over Printed Name School Registrars Signature over Printed Name

Date: ___________________________


Electronics Comm. & Service Tech. (ECST)
BS in Information Technology (BSIT)
BS in Office Administration (BSOA)


TO THE COLLEGE DEAN/REGISTRAR/ADVISER/GUIDANCE COUNSELOR:

The bearer is presently applying for Admission in CSPC for School Year . In this regard, may we ask
for your assistance to fill up the necessary information needed in assessing the student. Thank you very much and God Bless.

ACADEMIC PERFORMANCE

GRADE POINT AVERAGE:

This student belongs to the:

Upper 10% Upper 20% Upper 40% Lower 50% of the graduating class

CHARACTER ASSESSMENT

Emotional Stability
EXCELLENT VERY GOOD GOOD FAIR POOR

Conscientiousness
Adherence to Rules & Regulations
Manner & Conduct
Industriousness and Perseverance
Social Attributes























NOTE TO THE COLLEGE DEAN/REGISTRAR/ADVISER/GUIDANCE COUNSELOR: Please place this Admission Application on a
sealed mailing envelope and affix your signature outside for confidentiality. Thank you.

REQUIREMENTS FOR TRANSFEREES:
Duly accomplished Application Form;
Two (2) copies of 1 1/2 by 1 1/2 inch pictures w/ blue background;
Attached certified true copies of Report Card, Transcript of Records, Certificate of Good moral
character/Honorable Dismissal; and National Career Assessment Examination (NCAE) Result;
Testing Fee PHP. 50.00; and
Testing Fee Receipt from the Cashiers Office.

COURSES OFFERED:
CSPC Nabua Campus CSPC Buhi Extension Campus
BS in Nursing (BSN)
BS in Information Technology (BSIT)
BS in Electronics Engineering (BSECE)
BS in Civil Engineering (BSCE)
BS in Mechanical Engineering (BSME)
BS in Electrical Engineering (BSEE)


GRADUATE PROGRAMS

Master of Arts in Nursing (MAN)
Master in Engineering (ME)
Master in Business Management (MBM)
( This application form is not for sale! This application form is not for sale!)



Effectivity Date: November 2013 Rev.1 Page: 2 of 2