XAVIER UNIVERSITY - ATENEO DE CAGAYAN %Rank
ADMISSIONS OFFICE (CSAT/ATCU) OLSAT
TEL. No.:(08822)723116 (088)8583116 Local 2054, 2055, 2064
EMAIL:
[email protected] WEBSITE: www.xu.edu.ph English:______ SAI: _____
APPLICATION FORM AFFIX
Math: ______ %Rank:_____
Please print this in a LONG SIZE BLUE PAPER RECENT Science:______ Stanine:_____
PHOTO IR: ______
Office Use
1x1 GSA: ______ (Do not fill up)
FRESHMEN ( ) TRANSFEREE ( ) CIT ( )
NAME:__________________________________________________________________
Last Name First Name Middle Name _____________________
SCHOOL LAST ATTENDED:_____________________________________________________ COURSE
SCHOOL ADDRESS:____________________________________________________________________ DATE ATTENDED:______________________
HOME ADDRESS:__________________________________________________________________________________________________________
# street Town/Barrio City Province Postal Code
CDOC ADDRESS:______________________________________________________________________ TELEPHONE NO.:(_____)_______________
DATE OF BIRTH:_________________CIVIL STATUS:________________ RELIGION:_______________________ AGE:________________________
CITIZENSHIP:___________________EMAIL: _____________________ LANGUAGE/S SPOKEN:______________ SEX:________________________
EDUCATIONAL BACKGROUND
List all grade schools, high schools and vocation/technical course attended
NAME OF SCHOOL INCLUSIVE DATES/YEARS DEGREE, HONORS, AWARD RECEIVED
PRIMARY:___________________________________________ ____________________ ________________________________________
ELEMENTARY:________________________________________ ____________________ ________________________________________
SECONDARY:________________________________________ ____________________ ________________________________________
VOCATIONAL/TECHNICAL COURSE:____________________ _________________ __________________________________
FAMILY BACKGROUND
FATHER’S NAME:________________________________________________________ AGE: ____________ OCCUPATION:___________________
WORKING WITH:________________________________________________________ COMPANY’S ADDRESS:______________________________
MOTHER’S NAME:________________________________________________________ AGE: _____________ OCCUPATION: __________________
WORKING WITH:________________________________________________________ COMPANY’S ADDRESS:______________________________
OR SPOUSE :___________________________________________________________ AGE: _____________ OCCUPATION: __________________
GUARDIAN’S NAME:______________________________________________________________ RELATIONSHIP:_____________________________
ADDRESS:______________________________________________________________________TEL. NO.:__________________________________
NUMBER OF SIBLINGS IN THE FAMILY:______________________ (name and their level of education from the eldest to the youngest)
NAME AGE LEVEL OF EDUCATION
1. _____________________________________________ ______________ ________________________________________
2.______________________________________________ ______________ ________________________________________
3.______________________________________________ ______________ ________________________________________
4.______________________________________________ ______________ ________________________________________
5.______________________________________________ ______________ ________________________________________
FOR TRANSFEREE ONLY FOR RETURNEE ONLY
LIST ALL UNIVERSITIES AND/OR COLLEGES YOU HAVE ATTENDED HAVE YOU TRANSFERRED/ATTENDED ANY UNIVERSITY OR COLLEGE
AND INCLUSIVE DATES. PLEASE ARRANGE TO HAVE OFFICIAL WHILE YOU STOP SCHOOLING IN XU?
YES
NO IF “YES” PLEASE
TRANSCRIPT SENT TO THE UNIVERSITY REGISTRAR’S OFFICE OF ARRANGE TO HAVE OFFICIAL TRANSCRIPT SENT TO THE UNIVERSITY
XU-ATENEO. (Failure to disclose previous attendance at another institution REGISTRAR’S OFFICE OF XU-ATENEO. LIST ALL UNIVERSITIES AND/
could result in academic dismissal) OR COLLEGES YOU HAVE ATTENDED AND INCLUSIVE DATES.
SCHOOL INCLUSIVE DATES SCHOOL INCLUSIVE DATES
__________________________ __________________ _____________________________________________
_____________________________________________
__________________________ __________________ _____________________________________________
__________________________ __________________ LAST SY ENROLLED WITH XU ?____________________________
NO. OF SEMESTER YOU HAVE STOPPED ?___________________
SEMESTER COURSE:____________________________________
REASON(S) WHY QUIT SCHOOL ?
FOR FOREIGN STUDENT ONLY _____________________________________________
z
FOR WHICH YEAR OF STUDY?____________________________ z_____________________________________________
_____________________________________________
z
FROM WHAT COUNTRY? ________________________________
PLEASE ANSWER THE FOLLOWING QUESTIONS:
WHAT WERE THE IMPORTANT FACTORS IN YOUR DECISION TO APPLY TO XU-ATENEO?
1._________________________________________________________________________________________________
2._________________________________________________________________________________________________
3._________________________________________________________________________________________________
WHO WERE THE PEOPLE WHO INFLUENCED YOU MOST TO CHOOSE XU-ATENEO?
1._________________________________________________________________________________________________
2._________________________________________________________________________________________________
3._________________________________________________________________________________________________
YOUR INTEREST/HOBBIES_____________________________________________________________________________________
__________________________________________________________________________________________________
ATTESTATION
I hereby agree to abide by all the rules and regulations which _______________________________________
apply to students of XU-Ateneo and acknowledge that my right Name & Signature of Father
to remain AT XU-Ateneo is subject to my observance of them.
The information in this application is complete and correct to
the best of my knowledge. I acknowledge that XU-Ateneo is
required to abide by the Freedom of Information and Protection _______________________________________
of Privacy legislation as it applies to universities. Name & Signature of Mother
______________________________________ _______________________________________
Student Signature Name & Signature of Guardian
(if applicable)
________________________________
Date
C O L L E G E C O U R S E S
COLLEGE OF ARTS & SCIENCES
BACHELOR OF ARTS IN:
Economics Philosophy History Filipino Sociology International Studies English Language & Literature
BACHELOR OF SCIENCE IN:
Biology Chemistry Mathematics Marine Biology Psychology
SCHOOL OF BUSINESS AND MANAGEMENT
B A C H E L O R O F S C I E N C E I N A C C O U N TA N C Y
BACHELOR OF SCIENCE IN BUSINESS ADMINISTRATION MAJOR IN:
Business Economics, Marketing Management, Financial Management
COLLEGE OF AGRICULTURE
BACHELOR OF SCIENCE IN AGRICULTURE MAJOR IN:
Crop Science, Animal Science, Agricultural Economics
BACHELOR OF SCIENCE in :
Agribusiness Agricultural Engineering Food Technology
BACHELOR OF SCIENCE IN DEVELOPMENT COMMUNICATION MAJOR IN:
Development Journalism, Educational Communication
SCHOOL OF EDUCATION
BACHELOR OF ELEMENTARY EDUCATION SPECIALIZATION IN:
General Education, Special Education, Pre-School Education
BACHELOR OF SECONDARY EDUCATION MAJOR IN:
English, Filipino, Mathematics, Biological Sciences
PROFESSIONAL EDUCATION (For non-education graduates)
DIPLOMA OF SPECIAL EDUCATION TEACHING PROGRAM
COLLEGE OF NURSING
BACHELOR OF SCIENCE IN NURSING
COLLEGE OF ENGINEERING
BACHELOR OF SCIENCE in:
Civil Engineering Chemical Engineering Electrical Engineering Mechanical Engineering
Electronics Engineering Industrial Engineering
BACHELOR OF SCIENCE IN COMPUTER SCIENCE MAJOR IN:
Information Technology, Software Engineering, Network Engineering
CENTER FOR INDUSTRIAL TECHNOLOGY - XU CIT
(3 YEAR TECHNOLOGY COURSES)
ELECTRONICS TECHNOLOGY with Certificate in:
1st Yr. (PC Operation NC II), 2nd Yr. Consumer Elex NC II), 3rd Yr. (Consumer Elex NC IV)
COMPUTER TECHNOLOGY SPECIALIZATION ON CALL CENTER with Certificate in:
1st Yr (PC Operation NC I ), 2nd Yr (Computer Hardware Servicing)
MECHANICAL TECHNOLOGY MAJOR IN METAL WORKING with Certificate in:
1st Yr (Machining NC 1), 2nd Yr (Machining NC II), 3rd Yr (Machining III)
MECHANICAL TECHNOLOGY MAJOR IN AUTOMOTIVE with Certificate in:
1st Yr (Automotive Servicing NC II), 2nd Yr (Automotive Servicing NC III),
3rd Yr (Automotive Servicing NC IV)
