Republic of the Philippines

CAMARINES SUR POLYTECHNIC COLLEGES

Nabua, Camarines Sur
CSPC-F-STA-01

STUDENT TESTING AND ADMISSION OFFICE

APPLICATION FOR
CAMARINES SUR POLYTECHNIC COLLEGES COLLEGE ENTRANCE TEST
(CSPC-CET)

DATA SUBJECT ACKNOWLEDGEMENT AND INFORMED CONSENT:

“I hereby allow CSPC and its authorized personnel to collect and process the relevant data provided by me and
consent to the confidentiality bound performance of legitimate guidance functions such as counseling, admission of the
students, reporting, referrals, data security and compliance to legal requirements. I also have been aware of my data
privacy rights to be informed, to object, to access, to rectification, to erasure/blocking, and the damages and impact of
such rights towards psychological care. Further, I hereby declare that all the foregoing information provided by me is
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 in Camarines Sur Polytechnic
Colleges will be null and void and that CSPC is not in any way responsible for the misrepresentations I have declared.”

___________________________________________
SIGNATURE OVER PRINTED NAME

---------------------------------------------------------------------------------------------------------------------------------------------------

 SHS (Track/Strand: ________)  Transferee  2-year course Graduate

 HS Graduate (Year: _____)  ALS Graduate  Re-ad  TESDA/Vocational Course Passport
__________________________________________________________________________________
size
PREFFERED CAMPUS:  Nabua/Main Campus  Buhi Campus picture
Control Number: _____________________ GENERAL WEIGHTED AVERAGE: _______________
__________________________________________________________________________________

NAME: (fill out your name in the box provided) DATE OF FILING: - -
LAST NAME:

FIRST NAME:

MIDDLE NAME:

SEX:  MALE  FEMALE CITIZENSHIP: _____________RELIGION: ____________CONTACT NUMBER: ____________

DATE OF BIRTH: ___________________ AGE: _____________ PLACE OF BIRTH: ________________________________
(mm/dd/yyyy)
E-MAIL ADDRESS:  _________________________________________________________________________________________
NAME OF MOTHER: _____________________________OCCUPATION: ________________CONTACT NUMBER: _________
NAME OF FATHER: _____________________________ OCCUPATION:________________CONTACT NUMBER: _________
MONTHLY FAMILY INCOME: _________________________________________________________________________________
PERMANENT ADDRESS: ____________________________________________________________________________________
LAST SCHOOL ATTENDED: _________________________________________________________________________________
ADDRESS: _______________________________________________________________________________________________

HONORS/AWARDS RECEIVED: 
TALENTS AND SKILLS: 
COMMUNITY INVOLVEMENT/S:
ORGANIZATION/S:

1. What College or University is your first choice? Second? Third?

2. In case you do not qualify for admission, where do you plan to pursue college? (Enumerate)
3. Course applied in CSPC: 1st Priority  2nd Priority  3rd Priority  _______
4. Reasons why you want to study in CSPC?
_______
6. Do you have any other financial assistance? Specify  _______
7. Do you belong to a household that is or was a beneficiary of 4Ps? ___________________________________________________

 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. God bless!

Effectivity Date: October 2020 Rev.7 Page 1 of 2

 Republic of the Philippines
CAMARINES SUR POLYTECHNIC COLLEGES
Nabua, Camarines Sur
CSPC-F-STA-01

REQUIREMENTS:
For Grade 12 graduating students:
 Duly accomplished Application Form (CSPC-F-STA-01);
 One (1) pc. of original passport size picture in blue background
 Photocopy of Form 137 (Grade 11) with GWA
 Scanned softcopy of the Application Form (CSPC-F-STA-01) saved as PDF and send to
cspcstudenttesting@[Link]
 File name: (Last Name, First Name, Middle name)
For High School Graduate:
 Duly accomplished Application Form (CSPC-F-STA-01);
 One (1) pc. of original passport size picture in blue background
 Photocopy of Form 137 with GWA
 Scanned softcopy of the Application Form (CSPC-F-STA-01) saved as PDF send to
cspcstudenttesting@[Link]
 File name: (Last Name, First Name, Middle name)
For Transferees and 2-year course Graduates:
 Duly accomplished Application Form (CSPC-F-STA-01);
 One (1) pc. of original passport size picture in blue background
 Photocopy of Transcript of Records (TOR) with GWA
 Scanned softcopy of the Application Form (CSPC-F-STA-01) saved as PDF and send to
cspcstudenttesting@[Link]
 File name: (Last Name, First Name, Middle name)
For TESDA/Vocational Course and ALS:
 Duly accomplished Application Form (CSPC-F-STA-01);
 One (1) pc. of original passport size picture in blue background
 Photocopy of Report Card
 Scanned softcopy of the Application Form (CSPC-F-STA-01) saved as PDF and send to
cspcstudenttesting@[Link]
 File name: (Last Name, First Name, Middle name)
For Re-admission students:
 Duly accomplished Application Form (CSPC-F-STA-01);
 Duly accomplished Re-admission form
 One (1) pc. of original passport size picture in blue background
 Photocopy of most recent grades
 Scanned softcopy of the Application Form (CSPC-F-STA-01) saved as PDF and send to
cspcstudenttesting@[Link]
 File name: (Last Name, First Name, Middle name)

COURSES OFFERED:
CSPC Nabua Campus
CSPC Buhi Extension Campus
 BS in Nursing (BSN)  BS in Office Administration (BSOA)
 BS in Midwifery (BSM)  BS in Information Technology (BSIT)
 BS in Information Technology (BSIT)
 BS in Information Systems (BSIS)
 BS in Computer Science (BSCS)
 Bachelor in Library & Information Science (BLIS)
 BS in Electronics Engineering (BSECE) GRADUATE SCHOOL PROGRAMS
 BS in Civil Engineering (BSCE)
 BS in Electrical Engineering (BSEE)  Master of Arts in Nursing (MAN)
 BS in Mechanical Engineering (BSME)  Master in Engineering (ME)
 BS in Hospitality Management (BSHM)  Master in Business Management
 BS in Office Administration (BSOA) (MBM)
 BS in Entrepreneurship (BSEM)
 BS in Tourism Management (BSTM)
 BS in Mathematics (BS Math)
 BS in Development Communication
 Bachelor of Special Needs (Generalist)
 AB in English Language (AB Eng)
 Bachelor of Physical Education
 Bachelor in Technical Vocational Teacher Education (BTVTEd)
o Major in:
 Food Service Management
 Electronics Technology
 Fish Processing

Effectivity Date: October 2020 Rev.7 Page 2 of 2