Document Code: QF-ADM-01 Revision Number 01

Benguet State University-Admission Effectivity August 20, 2018 Ctrl No.

Test
Application Form
GENERAL GUIDELINES
• The BSU– Admission Test is for applicants who have not taken it for the past two years. If you have taken the examination already but
did not enroll and intend to enroll in the university, you are advised to visit the OSS-SWS-TMDU for further instructions.
• Submit the accomplished application form and requirements on or before ____________________ at room. 4 , 2nd floor , Office of
Student Services for processing. Walk-in applicants will not be entertained on the day of the examination. Submitted documents in
compliance with the admission test requirements shall become the property of BSU and are not to be returned to the applicant.
• Schedule of the BSU-Admission Test will be identified upon filing of the application form.
• The “no permit no exam” policy shall be implemented during the scheduled examination.
• In the event that the applicant cannot come on the scheduled examination date, a rescheduling shall be made after payment of Php
50.00 at the University Cashiers Office.
• The date of releasing of the BSU– Admission Test result shall be announced after the examination.
• Admission of applicants will depend on the admission guidelines and requirement of each College/ Institute.

BSU-AT Requirements
Academic Status of Applicant
Currently enrolled Grade 12
student expected to graduate
Senior High School graduate
Transferee
(Student who enrolled in any
tertiary level school but wish to
transfer in BSU)
Required Documents
฀ Certificate of enrollment from the School Registrar/Principal
฀Two certified photocopies of Grade 11 report card with General Weighted Average duly signed by the
Principal
฀Original and two (2) photocopies of Grade 12 Report Card
฀Endorsement Slip (obtained from the intended College to enroll at BSU) duly signed by the
Dean/Director
฀Two (2) photocopies of Certified True Copy of Grades

฀Accomplished BSU-AT Application form (may be obtained at Rm. 4 , 2nd floor Office of Student
Services, Km. 6 , La Trinidad, Benguet or can be downloaded from www.bsu.edu.ph)
All Applicants ฀Two (2) recent 2x2 ID picture (formal studio) with white background and name tag (signature over
(other requirements to be printed name)
submitted) *** If married, please attach a photocopy of your Marriage Certificate ***
No Testing Fee will be collected

The following are Undergraduate Degree Programs requiring the BSU– Admission Test

LA TRINIDAD Campus College of Teacher Education (CTE)

BEEd Bachelor of Elementary Education
Code Degree Programs BECEd Bachelor of Early Childhood Education

BSA Bachelor of Science in Agriculture BPEd Bachelor of Physical Education

BSAB Bachelor of Science in Agribusiness BSEd Bachelor of Secondary Education
BSDC Bachelor of Science in Development BTLEd Bachelor of Technology and Livelihood
Communication Education

College of Arts and Sciences (CAS) College of Veterinary Medicine (CVM)

AB Fil Bachelor of Arts in Filipino DVM Doctor of Veterinary Medicine
AB ELS Bachelor of Arts in English Language Studies
AB Comm Bachelor of Arts in Communication Institute of Human Kinetics (IHK)
BSES Bachelor of Science in Environmental Science BSESS Bachelor of Science in Exercise and
BSIT Bachelor of Science in Information Technology Sports Sciences
BSS Bachelor of Science in Statistics
Institute of Public Administration (IPA)
College of Engineering and Applied technology (CEAT) BPA Bachelor in Public Administration
BSABE Bachelor of Science in Agricultural and
Biosystems Eng’g
BUGUIAS Campus
College of Home Economics and Technology (CHET)
Code Degree Programs
BS Entrep Bachelor of Science in Entrepreneurship
BEEd Bachelor of Elementary Education
BSHE Bachelor of Science in Home Economics
BSEd Bachelor of Secondary Education
BSHM Bachelor of Science in Hospitality Management
BPEd Bachelor of Physical Education
BSND Bachelor of Science in Nutrition and Dietetics
BTVTEd Bachelor of Technical Vocational Teacher
Education
College of Forestry (CF)
BSF Bachelor of Science in Forestry
BOKOD Campus
College of Nursing (CN)
BSN Bachelor of Science in Nursing Code Degree Programs
BEE Bachelor of Elementary Education
BTLEd Bachelor Technology and Livelihood Education
BSInT Bachelor of Science in Industrial Technology
BTVTEd Bachelor of Technical Vocational Teacher
Education

More at the back 1 of 2

College of Agriculture (CA) BLIS Bachelor of Library and
Information Science Applicant No. __ __ __ __ __ __- __-__ __ __
 TO THE STUDENT
Read carefully the College Admission Requirements before filling out this application form STAPLE 2 pcs. of recent 2”
. x 2”
TYPE OR PRINT LEGIBLY all information needed and then place a check ()mark in the ID picture (formal Studio)
appropriate box. with white background and
O ly appli atio for a o plished orre tly a d o pletely will e pro essed. name tag (Signature over printed
name)

[ ] Currently enrolled as Grade 12 Student [ ] Transferee

[ ] Senior High School Graduate [ ] Second (2nd) Degree
Pictures taken using cell
[ ] ALS /PEPT Passer [ ] Others (please specify): ______________
phone camera will not be
accepted
ACADEMIC STATUS OF APPLICANT
BACKGROUND INFORMATION
Last Name

First Name

Middle Name
Sex: [ ] Male [ ] Female Birth Date (MM/DD/YY) : ___/___/___ Age: ______ Civil Status: [ ] Single
Citizenship: [ ] Filipino [ ] Foreign (Specify) _______________ [ ] Dual (Specify) _______________ [ ] Married
Nationality: [ ] Filipino [ ] Foreign (Specify) _______________ [ ] Separated
[ ] Widow/Widower
CONTACT INFORMATION
Permanent Home Address
________________________________________________________________________________________________________________
House No. & Name of Street District/Barangay/Subdivision Municipality (Town)/ City

_____________________________________________________________________________________ Zip code: ____________

Province Country/State

Telephone/ Mobile No. (required): _____________________ Email Address (required):

___________________________________

Last school attended or where you are currently completing Secondary Level Education
Name of School (Please specify if Main or Annex Campus.):
_____________________________________________________________________
Complete Address: ________________________________________________________________________________
Type of School: [ ] Public [ ] Private [ ] Others, Pls. Specify _____________________
Do you have any PHYSICAL DISABILITY OR CONDITION that requires special attention or would make it difficult for you to take
a regular test? [ ] No [ ] Yes (specify) ______________________________________________________________________

DEGREE PREFERENCE (considering the list of degree programs on page 1, write your preferences below )
REMINDERS: The University has three (3) campuses (La Trinidad, Buguias, Bokod). Degree programs are listed under the campus where it is
offered . Some of it are offered in two or more campuses hence take note of the campus where you are applying. Assess your degree choice
wisely. Your examination result will be evaluated according to your first choice of degree program you have indicated in this form. Each
degree program offered has a cut-off score you need to obtain in order to qualify. If your examination result does not qualify you to your first
preference, you may choose your second or third choice . However, your examination result will be re- evaluated according to the cut-off
score and the availability of slot on your next choice.

Degree Program applying for:

Code Complete Name of Degree Program Campus
First Choice

_________ ______________________________________________ [ ] La Trinidad [ ] Buguias [ ] Bokod

Example: BSA Bachelor of Science in Agriculture

Write your second (2) and third (3) choice. This will help the evaluator for your second and third choice if you do not make it in your
primary preference of degree program. Your score will be re-evaluated and subject to the availability of slot.
Second Choice

_________ [ ] La Trinidad [ ] Buguias [ ] Bokod

______________________________________________
Third Choice

______________________________________________
_________ [ ] La Trinidad [ ] Buguias [ ] Bokod

ATTESTATION
I affirm that I have read and understood all the instructions contained in this application form and that the information
supplied are true, complete and accurate. I promise to abide by the rules and regulations of Benguet State University
regarding the BSU-Admission Test and my possible admission to the University. I am aware that any information I have
concealed, falsely given and/or withheld is enough basis for the disqualification of my application .

Attested by:

____________________________________ ___________ _______________________________________ ____________

Student Date Parent or Legal Guardian Date
(signature over printed name) (signature over printed name)
 2 of 2
This form may be reproduced but not for sale.