Application For Admission Form

Control No.
CITY COLLEGE OF DAVAO

Km. 10 Catalunan Pequeño, Davao City
APPLICATION FOR ADMISSION FORM
Semester: _ FIRST__________ Academic Year: ________________
PROGRAM (Check ONLY ONE):

2x2 ID Picture
☐ Bachelor of Early Childhood Education with
☐ Bachelor of Technical Vocational Teacher Education
☐ major in Heating, Ventilation, Air Conditioning and Refrigeration Technology WHITE
☐ major in Computer Programming
☐ BS in Entrepreneurship BACKGROUND
STUDENT DETAILS
First Name: ________________ Middle Name:__________________ Last Name: ____________________ Suffix (Jr,II, etc.): ____
Birth Date: _______________________ Birth Place: ___________________________ Age: _______ Gender: __________
Landline No.: __________________ Mobile No.: ________________________________ Status:_______________________
Email Address: ___________________________________________________ Nationality: _____________________________
Residential Address: ______________________________________________________________________________________
Are you a member of Indigenous Peoples Group? ☐ Yes ☐ No If yes, specify: ______________________________________
Senior High School
Name of School: ___________________________________________________________ Year Graduated: _______________

☐ ALS ☐ Late Afternoon ☐ Regular SHS (Private) ☐ Regular SHS (Public)
Academic Strand / Track: _______________________________________________ General Weighted Average: ____________
FAMILY BACKGROUND
Father’s Name: _____________________________________ Mother’s Name: _____________________________________

Permanent Address: _________________________________ Permanent Address: _________________________________
__________________________________________________ __________________________________________________
Occupation: ________________________________________ Occupation: ________________________________________
Contact No.: _______________________________________ Contact No.: ________________________________________
Combined Annual Income: ☐ Php 50,000.00 and below ☐ Php 51,000.00 – P60,000.00 ☐ Php 60,000.00 and above
Control No.
ACKNOWLEDGEMENT RECEIPT
Name of Student-Applicant: ________________________________________ Date of Submission: ______________________
This is to acknowledge the receipt of your Application for Admission Form for the First Semester of the School Year
______________. Your application will undergo a screening process.
If your application is successful, you will receive NOTICE OF ADMISSION via email on or before _______________. Please
respond to the email within three working days to secure your slot.
Application Received by: _____________________________________/_______________

Name and Signature Date
SUBMITTED CREDENTIALS (Please arrange your documents in this order):
☐ PSA Birth Certificate

☐ Certificate of Residency issued by the Office of the Barangay Chairman
☐ Income Tax Return (ITR) of both parents or Certificate of Low Income issued by the City Social Services
and Development Office (combined annual net income of both parents must be stated)
☐ Certificate of Belonging to Indigenous Peoples Group issued by the Indigenous People Mandatory
Representative (IPMR) (for IP Members only)
☐ Recent Senior High School Report Card (SF9) or Appropriate ALS Certificate (for ALS Graduate only)
☐ Certificate of Good Moral Character
I hereby declare that the information I provided and attached to this document is true and correct. I also understand
that any willful dishonesty will result in the DISQUALIFICATION of this application. I acknowledged that my application
for admission will go through screening process and that I will be informed through email and/or text message on the
result of my application once I am qualified. I recognize that if this application is successful, I or my representative
should respond to the email within three working days; otherwise, my slot will be forfeited. I further understand that
only those who will RECEIVE the NOTICE OF ADMISSION will proceed to official enrollment.
_____________________________________
Name and Signature of Student-Applicant
_____________________________________
Date

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Control No.

CITY COLLEGE OF DAVAO

APPLICATION FOR ADMISSION FORM

Semester: _ FIRST Academic Year: ______

PROGRAM (Check ONLY ONE):

Senior High School

Name of School: _____________________________________________ Year Graduated: _

Father’s Name: _ Mother’s Name: _

Name of Student-Applicant: __________________ Date of Submission:

Application Received by: _______________________/_

☐ PSA Birth Certificate

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