Cat Application Form2024

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COLLEGE ADMISSION APPLICATION FORM Latest 2”x 2”ID picture in

white background
with name tag

Application Date: Are you a first-time DMMMSU applicant?


Batch No. (For DMMMSU use only): Yes No
Control No. (For DMMMSU use only): Are you already vaccinated?
Yes No
Name (Pls. Print): GAO-AN JAYZEL MAE REINTEGRADO
Last Name First Name Middle Name

LRN: Birthdate: Age Citizenship: Filipino Foreigner (Specify)


Home Address:
(Barangay) (Municipality/City) (Province) (Zipcode)
E-mail Address: Active Mobile No. Sex:
Please Check:
Incoming Freshman
School from which you graduated:
Address:
Track: Strand:
School Year Graduated:
Type of School: Private Public
Transferee
School last attended:
Address: Sem/SY:
Type of School: Private Public
Campus Preference: NLUC MLUC SLUC OUS
Course Preference: First Priority: Second Priority:

I hereby declare that all information in this application is true


and correct. I understand that any false information may be a
ground for disqualification for Admission in the University. Processed by:

Name and Signature of Applicant Name and Signature of SAS Personnel Date

COLLEGE ADMISSION TEST REQUIREMENTS:


1. Two (2) pieces 2”x2” identical latest I.D. picture with name tag in white background
2. FOR LIFE-LONG LEARNERS: Photocopy of Form 138/ Report Card
FOR SENIOR HIGH SCHOOL STUDENTS / GRADUATES: FORM 138 /Report Card (Grade 12) (First Semester grades, signed by the
School Head/Principal)
FOR TRANSFEREES: Transcript of Records or Certified True Copy grades.

DMMMSU-SAR-F051
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DON MARIANO MARCOS MEMORIAL STATE UNIVERSITY


La Union, Philippines

COLLEGE ADMISSION TEST


EXAMINATION PERMIT/CLAIM SLIP
Latest 2”x 2”ID picture in
Application Date: white background
Batch No.: with name tag
Control No.:

Name (Pls. Print) GAO-AN JAYZEL REINTEGRADO


Last Name First Name Middle Name
Date of Examination: Testing Center: MLUC
Time of Examination: Building: Room:

Supervising Examiner

Thank you for submitting your application to DMMMSU! Kindly bring this examination permit and blue ballpen on the scheduled date and
time of examination. The results of the examination will be released on JULY 8-12, 2024 at the Guidance and Counseling Office. Present this claim
slip. Interview and registration will be scheduled for qualified applicants.

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