Republic of the Philippines

DEPARTMENT OF EDUCATION
Cordillera Administrative Region
Schools Division of Benguet
Cordillera Regional Science High School ATTACH ID HERE
Wangal, La Trinidad, Benguet
Tel. Fax (074) 422-5662 1.5 x 1.5
SchooI lD No.305140

APPLICATION FOR ADMISSION

Please print legibly all information required. Place X marks in appropriate blanks.

PERSONAL DATA

FAMILY NAME:

FIRST NAME:

MIDDLE NAME:

PRESENT ADDRESS: _________________________________________________________________________________________________

PROVINCIAL ADDRESS: ______________________________________________________________________________________________

DATE OF BIRTH: ________________________________________ AGE: __________

MALE:____ FEMALE:____
CITIZENSHIP: ___________________________________

SCHOOL PRESENTLY ENROLLED IN, and SCHOOL ADDRESS:

________________________________________________________________________________________________________________

EMAIL ADDRESS: _______________________________________________

PARENTS PROFILE

FATHERS NAME: MOTHERS NAME: (Maiden name)

Last Name First Name M.I. Last Name First Name M.I.
PRESENT ADDRESS: PRESENT ADDRESS:

PROVINCIAL ADDRESS: PROVINCIAL ADDRESS:

WORK ADDRESS: WORK ADDRESS:

TELEPHONE NUMBER: TELEPHONE NUMBER:

MOBILE PHONE: MOBILE PHONE:

I (we) certify that all information on this application is accurate and complete.

_________________________________ __________________________________
Signature over printed name of STUDENT Signature over printed name of PARENT

ACKNOWLEDGEMENT RECEIPT
Date:________________________
Attach ID here
1.5x1.5 Received from ___________________________________________________________________

the sum of Two Hundred Pesos only (P200.00) as payment for CRSHS examination fee.

___________________________________________
Signature over Printed Name

This form can be duplicated.

 THE CORDILLERA REGIONAL SCIENCE HIGH SCHOOL
Dear Parents/Guardians,
Thank you for considering Cordillera Regional Science High School. This form contains the admission
process of our institution and we are more than willing to assist you in the process. For your queries and
more information, please contact the school at telephone number: 422-5662.
The Cordillera Regional Science High
School is one of the leading academic institutions in
the Cordillera Region. Since its establishment in
1994, their achievements in both curricular and co-
curricular activities are unrivaled. For years, the
school strived for the attainment of its mission to
serve as a wellspring of excellent Science and
Mathematics-oriented education and to produce
competent, inventive, and dynamic students.
With its sophisticated instructional
materials, technology-rich and harmonious
environment, it has fashioned leaders and
professionals who are successful in their own
endeavors. More than academics, the school offers
culturally-enriched and life skills education. In
recognition of the school’s unceasing commitment to
excellence, the Department of Education and
numerous institutions bestowed awards and
appreciations.
ADMISSION REQUIREMENTS:
 Completely filled out Application Form to
be submitted on or before 5:00 p.m. on
December 8, 2017
 Photocopy of Form 138E bearing the grades
for the 1st Grading Period
 No grades lower than 80 in all learning areas
in Grade VI
 PHP 200.00 application fee (non-
refundable)
APPLICATION PROCESS:
Step 1: Submission of Requirements
The Application Form and a photocopy of FORM
138E should be submitted to the school not later than
the day before the scheduled first screening test.
Step 2: First Screening
The first stage is the administration of a standardized
mental ability and aptitude test to be administered by
a licensed psychologist. The student-applicant should
belong to the top 40% of the total examinees in order
to advance to the second stage.
The tests schedule and venue of examination will be
posted by the school a day before the test. Student-
applicants are required to bring TWO (2) pieces of
NUMBER 2 MONGOL PENCILS.
Results will be posted on the bulletin board and will
be sent to the student’s respective elementary school
after 10 working days.
For the First Screening:
 Bring 2 pieces #2 Mongol pencil
 First batch should be at the testing
area at 8:00 a.m. while the second
batch should be at the testing area
at 9:00 a.m.
The CRSHS Administration and Staff
Step 3: Second and Third Screening
Qualified applicants for this stage are those
applicants who passed the First Screening test and
should have grades of 80% and above in all subjects
for the 1st and 2nd grading.
The students-applicants should bring with them TWO
(2) pieces of NUMBER 2 MONGOL pencils. The
student is permitted to take his/her snack while the
test is conducted.
The second stage is the proficiency test in English,
Science and Mathematics followed by an interview
with the student and his/her parents.
After the test, the third screening which is an
interview of the student and the parent by the CRSHS
Admission Committee will be conducted. The
interview shall be rated in accordance to a prepared
rubric and shall be an integral part of the score
obtained by the student. The student will be notified
of the results of the second and third screening
through a letter addressed to his/her respective
elementary school.
THE FINAL SCORE
The following shall be the basis for the computation
of the student-applicants final score:
90% from the PROFICIENCY TEST
10% from the INTERVIEW WITH STUDENT
APPLICANT AND HIS/HER PARENT
The qualified incoming Grade 7 students should have
grades of 80% and above in all grading period in
Grade VI to be able to enroll.
SUMMER ENCAMPMENT FOR
NEW STUDENTS
The qualified incoming Grade 7 shall also be
required to join the encampment in May 2018. This
encampment was conceptualized to let the incoming
students gain a grasp of some activities in store for
them in the different subject areas and for them to
bond with each other as they start a new school year
in a new environment. It will also provide a ‘hands
on, minds on”, experience in all subject areas where
the students can develop their social learning
capabilities by exposing them to varied fun activities
and to enhance experiential learning among students.
For the Second and Third Screening:
 Bring 2 pieces #2 Mongol pencil, and snack
 Applicants should be at the testing area before
7:30 a.m.
 While the applicants are having their test, their
parents will be interviewed at the CRSHS Library.
 The applicants will be interviewed just after their
test.