San Beda College
College of Arts and Sciences
P.O. Box 4457 Manila 1099
Telefax: 7348062
Trunkline: 7356011 to 15 loc 3117
Website: www.sanbeda.edu.ph
(2 x 2)
APPLICATION FORM
IMPORTANT: Fill out this form with required information. Do not leave any item unanswered.
Write NA if not applicable. Print this form and the 2 recommendation forms, put in a long
brown envelope with all your credentials. THIS APPLICATION FORM SHOULD BE
COMPLETED SOLELY BY THE APPLICANT, OTHERWISE THE APPLICATION WILL BE
RENDERED NULL AND VOID.
PERSONAL AND FAMILY BACKGROUND
NAME ________________________________________________________________________________________
Print:
Last
First
Middle
Nickname
ADDRESS IN METRO MANILA ____________________________________________________________________
Tel/Fax/Cell/Email ______________________________________________________________________________
PERMANENT ADDRESS ________________________________________________________________________
Tel/Fax/Cell/Email ______________________________________________________________________________
DATE OF BIRTH __________________ PLACE OF BIRTH _________________ AGE _______ SEX __________
CITIZENSHIP _____________________ RELIGION _____________________ CIVIL STATUS ________________
SPOUSE (if applicable) _________________________________ Age _________ Occupation __________________
Are you living with your wife/spouse/children? ________ if no, please give details _____________________
NO. & NAMES/AGE OF CHILDREN (if applicable) ______________________________________________________
GENERAL HEALTH: (Encircle) Excellent/Good/Fair/Poor. State any peculiar disease or ailment that should be taken
into consideration in planning your study program and daily activities (e.g., hearing, reading speech difficulties;
physical
disabilities,
allergies,
emotional
disturbances,
etc.
)
_____________________________________________________
NAME OF PHYSICIAN & TEL. NO. _________________________ DATE OF LAST PHYSICAL EXAM ___________
HAVE YOU EVER STOPPED OR BEEN FORCED TO STOP STUDYING FOR TWO WEEKS OR MORE?
YES
NO. GIVE DETAILS AND DATES ________________________________________________
______________________________________________________________________________________________
IN CASE OF EMERGENCY, PLEASE CONTACT: (Give Full Name, Address, Tel. No. and relation) ______________
______________________________________________________________________________________________
Living
FATHER
Deceased
Living
When? ___________
MOTHER
Deceased
GUARDIAN
State your relationship
or affiliation with the
guardian: __________________
When? __________
Name ____________________________ ____________________________ _____________________________
Age ______________________________ ____________________________ _____________________________
Residence _________________________ ____________________________ _____________________________
Citizenship _________________________ ____________________________ _____________________________
Religion ___________________________ ____________________________ _____________________________
Occupation,
Position____________________________ ____________________________ _____________________________
Business
Address ___________________________ ____________________________ _____________________________
Contact No. ________________________ ____________________________ _____________________________
E-mail ____________________________
____________________________ _____________________________
If your parents are both alive, are they living together?
Gross Monthly Family Income
YES
Below 10,000
10,000-30,000
51,000-70,000
above 70,000
NO
please give details:
31,000-50,000
Do you have relatives who are attending or have attended San Beda College? Give names, relationship and if
possible, dates of attendance: _____________________________________________________________________
EDUCATIONAL BACKGROUND
List in order, beginning from the lowest, ALL schools attended, including primary, intermediate and high school. If you
have taken any courses above the high school level, list the college and/or professional school attended. This must be
a COMPLETE listing of every school in which you have enrolled.
GRADE SCHOOL
ADDRESS
GRADE LEVEL
_______________
YEARS
ATTENDED
FROM TO
_______________
__________________
_______________________
__________________
__________________
HONORS
AWARDS
____________
_______________________
_______________
_______________
____________
_______________________
_______________
_______________
____________
HIGH SCHOOL
__________________
_______________________
_______________
_______________
____________
__________________
_______________________
_______________
_______________
____________
COLLEGE (if you have attended any other college) or other VOCATIONAL/TECHNICAL SCHOOLS)
__________________
_______________________
_______________
_______________
____________
__________________
_______________________
_______________
_______________
____________
FINAL GRADE IN :
English
Math
Science
Gen. Average
Fourth Year H.S.
College Last Attended
(latest semester or 1st
semester, whichever is
available)
List of Failing Grades and
subjects
received
in
college
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
_____________________
_____________________
_____________________
_____________________
STANDING IN GRADUATING CLASS: (Please encircle) Top 10%, 25%
Lower 50%
Repeater ____________
APPROXIMATE SIZE OF GRADUATING CLASS ________ DATE OF GRADUATION FROM H.S. ______________
CHECK ACTIVITIES IN WHICH YOU HAVE PARTICIPATED IN HIGH SCHOOL OR IN THE LAST SCHOOL
ATTENDED OR IN YOUR COMMUNITY:
_____ Religious Organizations
_____ Student Government
_____ Speech Contest
_____ Community Outreach
_____ Civic Action Groups
_____ Dramatics
_____ School Paper
_____ Glee Club/Chorale
_____ Athletics/Sports
_____ Dance Club
_____ School Team
_____ Orchestra or Band
_____ None at all
_____ others
___________________________
Leadership Positions and organizations, at present (if any) ____________________________________________
SPECIAL TALENTS/SKILLS TRAINING _____________________________________________________________
HAVE YOU EVER BEEN DISMISSED OR PLACED ON PROBATION? _________ if yes, give the name of the school,
the dates and the reason/s _______________________________________________________________
______________________________________________________________________________________________
Do you have any work experience? ______ If yes, please list (in a separate sheet) the details of your employment
record, i.e., duration, employer, job description and position _______________________________________________
______________________________________________________________________________________________
HOW DID YOU COME TO KNOW ABOUT San Beda College? Please check as applicable:
_____ from parents/sibling
_____ from my friends/classmates
_____ from teachers/classmates
_____ from the internet/webpage
_____ from Career Orientation talks
_____ others (pls. Specify)
_____ from my own initiative
_____ from SBC brochures/poster
_______________________
PROPOSED PROGRAM OF STUDY
Please check the degree program you intend to pursue.
Write 1 for your first choice and 2 for your second course choice
Degree Programs:
BS Accountancy
BS Economics and Public Policy
BS Entrepreneurship
BS Human Biology
BS Information and Communication Technology
BS Legal Management
BS Psychology
BSBA Financial Management
BSBA Human Resource Development Management
BSBA Marketing and Corporate Communications
BSBA Operations Management
TO BOTH THE APPLICANT AND PARENTS/GUARDIAN, PLEASE READ ALL CONTENTS BEFORE SIGNING
I HEREBY APPLY FOR ADMISSION TO THE COLLEGE OF ARTS AND SCIENCES, SAN BEDA COLLEGE. IF ADMITTED, I AGREE
TO ABIDE BY ITS REGULATIONS. I CERTIFY THAT THE FOREGOING INFORMATION AND THE CREDENTIALS SUBMITTED ARE
TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I FULLY REALIZE THAT OMISSION OR FALSIFICATION OF ANY
INFORMATION AND CREDENTIALS WILL BE CONSIDERED SUFFICIENT REASON FOR REJECTION OF THIS APPLICATION OR
FOR DISMISSAL, EVEN IF ALREADY ADMITTED.
Attested By:
________________________________________________
Full Name & Signature of Applicant
_______________________________________________________
Full Name & Signature of Parents/Guardian
Date: __________________________________________
Contact Nos. ____________________________________________
San Beda College
COLLEGE OF ARTS AND SCIENCES
P.O. Box 4457 Manila 1099
Telefax 734.8062 Trunkline 735.6011 loc 3117
Website: www.sanbeda.edu.ph
LETTER OF RECOMMENDATION
TO THE APPLICANT: Complete the information below and give this form, along with an envelope addressed to CAS
BOARD OF ADMISSIONS c/o ADMISSIONS CENTER, SAN BEDA COLLEGE, MENDIOLA,
MANILA to two (2) persons who know you well enough to provide an accurate
recommendation, e.g., your class adviser, guidance counselor, or principal.
___________________________________________________________________________________ is applying for
Print:
Last Name
First Name
Middle Name
Admission to the College of Arts and Sciences of San Beda for the ______ Semester of Academic Year ___________
TO THE REFERENCE: Please Complete this form and place it in the envelope provided by the student. Seal and
sign the flap of the envelope. Envelopes which are unsealed and unsigned on the flap will not
be accepted. You may omit any questions which you do not feel qualified to answer. All
responses will be treated as strictly confidential.
A.
HOW LONG AND IN WHAT CAPACITY HAVE YOU KNOWN THE APPLICANT?
B.
ON A SCALE OF 1 TO 7, WITH 1 BEING POOR, 4 BEING AVERAGE, AND 7 BEING EXCEPTIONAL
HOW WOULD YOU RATE THE APPLICANT IN TERMS OF THE FOLLOWING? (If you feel you lack
sufficient information to give an accurate answer, please check the column x)
Poor
1
PERSONAL CHARACTERISTICS
1. Mental Ability
2. Oral Communication Skills
3. Written Communication Skills
4. Study Habits and Attitudes
5. Influence and Leadership
6. Maturity
7. Concern for Others
8. Social and Emotional Adaptability
9. Conduct
10.Masculinity/Femininity
(Physical
&
Behavioral
Ave.
4
Exc.
7
Manifestations)
C.
PLEASE INDICATE DATE OF ADMISSION AND LENGTH OF STAY OF THIS APPLICANT IN YOUR
SCHOOL.
D.
IN YOUR PROFESSIONAL JUDGMENT, WHAT RANK DOES THE APPLICANT BELONG TO IN
TERMS OF ACADEMIC PERFORMANCE? PLEASE PLACE A CHECK MARK IN THE BOX
CORRESPONDING TO THE RANK OF THE APPLICANT.
Top 10%
25%
50%
Below 50% of his/her class/section
Top 10%
25%
50%
Below 50% of senior/graduating class
Number of students in class/section _______________ in graduating class _____________
E.
SOME GIFTED INDIVIDUALS MAKE MEDIOCRE SCHOLASTIC RECORDS. IN YOUR OPINION IS THE
APPLICANTS SCHOLASTIC RECORD AN ACCURATE INDEX OF HIS/HER ABILITY? IF NOT, PLEASE
EXPLAIN BRIEFLY
F.
PLEASE INDICATE BY CHECKING THE APPROPRIATE BOX BELOW IF THE APPLICANT HAS BEEN
PLACED ON PROBATION DURING HIS/HER STAY IN YOUR SCHOOL
Academic
Disciplinary
Absences
Please explain briefly________
________________________________________________________________________________________
________________________________________________________________________________________
G.
PLEASE LIST ANY INFORMATION WHICH IN YOUR OPINION, WOULD BE HELPFUL TO THE ADMISSION
COMMITTEE. (e.g. Awards, Accomplishments, Talents, Weaknesses, Family Background, Interpersonal
Relationships, Perceptions of other people, extra sheet may be used, etc.)
H.
FROM YOUR OWN OBSERVATION AND AS ELICITED FROM FEEDBACK GIVEN BY OTHERS, WHAT ARE
THE ASPECTS OF HIS/HER SCHOOL PERFORMANCE AND PERSONALITY TRAITS THAT NEED
IMPROVEMENT.
I.
RECOMMENDATION:
I strongly recommend her/him for admission.
I recommend him/her for admission.
I recommend him/her for admission with some reservations.
I do not recommend him/her for admission.
SIGNATURE: ______________________________________________ Date: ____________________________________
NAME TYPED OR PRINTED: ___________________________________________________________________________
DESIGNATION/TITLE: _________________________________________________________________________________
INSTITUTION/ADDRESS: _______________________________________________________________________________
TEL/FAX NO./CELLPHONE: ____________________________________________________________________________
(Note: The CAS Board of Admissions may or may not contact you for confirmation of aforementioned data. Thank you)
