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    Admission Form

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    opiprime123

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    © All Rights Reserved
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    Admission Form

    Uploaded by

    opiprime123
    6 views2 pages

    Copyright

    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    6 views2 pages

    Admission Form

    Uploaded by

    opiprime123

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    STUDENT APPLICATION FORM

    Complete Name (Surname, Given Name, Middle Name):


    MARATCGA, EGGY GALLENTA
    Date of Birth: Gender:
    May 05, 2006 MALE
    PERSONAL

    Programs Applied For:


    ☑ Bachelor of Science in Marine Transportation (BSMT)
    ☐ Bachelor of Science in Marine Engineering (BSMarE)
    Place of Birth:
    Tacurong
    Civil Status: Religion: Age: Height (cm): Weight (kg):
    Single Baptist 17 6'0 60
    Address: Mobile Number: Telephone Number:
    Vsm phase1 blk22 lot30 brgy san isidro gsc, San Isidro (Lagao 2nd), General (+63) 994-627-8311
    Santos City, South Cotabato Email:
    [email protected]
    EDUCATIONAL BACKGROUND

    SENIOR HIGH SCHOOL


    Name of School: Address:
    Strand: Year of Graduation: GWA:
    RAMON MAGSAYSAY MEMORIAL 456C+JXQ, Beatiles St, General Santos City,
    humss 2024 89
    COLEGES South Cotabato
    COLLEGE
    Name of School: Address: Year of Graduation: Last Semester Attended:

    School Achievements/Honors/Awards: Skills (welding, computer programming, etc.):

    Organizations/Affiliations/Fraternity/Sorority/Extra-curricular activities involved in:

    Father's Name: Age: Occupation/Company: Monthly Income: Contact Number: Address:


    Maratcha, Edgardo Rivera Jobless I dont know Tacurong
    Mother's Name: Age: Occupation/Company: Monthly Income: Contact Number: Address:
    Maratcha, Amellia Gallenta Deceased None None
    FAMILY BACKGROUND

    Other Sources of Income: Monthly Income from other sources:


    None 50k
    Siblings:
    Name Date of Birth Civil Status Education Level Occupation/Company
    Relatives who are seafarers (if applicable):
    Name Company Position Relations
    Contact Person in Case of Emergency:
    Complete Name: Relationship:
    Loja, Izza
    Complete Address: Contact Number:
    Vsm phase1 blk22 lot30 brgy san isidro gsc, General Santos City, South Cotabato (+63) 930-528-5104
    Please put a checkmark if you have been diagnosed for or experienced any of the following conditions?
    ☐ ADHD ☐ Color Blindness (please go to link: https://www.colorlitelens.com/ishihara-test)
    ☐ Heart Disease ☐ Diabetes ☐ Unable to do strenuous activities ☐ Others : Cant speak well
    How much of school fees are you able to pay per semester?
    18k
    What are your primary sources to finance your studies at MMMA?
    ☐ Personal Savings ☐ Parents'/Relatives' Support ☐ Student Loan ☐ Others :
    HOW DID YOU LEARN ABOUT MMMA?
    ☑ Social Media ☐ Referral / Recommendation ☐ Career Talk
    ☐ Invited by Letter ☐ Promotional Posters / Tarps ☐ Other:
    REFERRED BY: (Specify)

    What city do you prefer to take MMMA Entrance Examination?


    General santos city

    I hereby certify that the above information are true and correct, and I willingly consent to process the foregoing
    data. Any material misrepresentation of facts herein will be sufficient grounds for disqualification.
    MMMA and the Applicant recognize the responsibilities under Republic Act No. 10173, also known as the Data
    Privacy Act of 2012, with respect to data collection, storing, accessing and/or processing of Personal Data. The Personal
    Data in this form will only be used for admission and selection processing.

    Applicant's Signature over Printed Name

    Documentary
    Program Minimum Education Qualifications
    Requirement
    BS Marine *Graduate or graduating of any *17 to 21 years old. *For SHS Graduate:
    Transportation Senior High School Program with *Single (never been married; no 1.Form 138 (Certified
    BS Marine GWA of at least 83%, with no child/children) True Copy)
    Engineering final grade lower than 80% in *At least 162.5 cm (male) or 157.5 cm 2.Certificate of Good
    any subject. (female) in height. Moral Character.
    *College level with grades not *Physically fit, no pre-existing medical 3.PSA Authenticated
    lower than 83% in any subject. condition or taking maintenance Copy of Birth Certificate.
    medicine (heart, respiratory, diabetes,
    hypertension, color blindness, ADHD, *For College Level:
    etc). 1.Certification of Grades
    from previous school.
    2.Honorable Dismissal
    from the previous school
    3.PSA Authenticated Birth
    Certificate

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