BSU-SOP-01-F01 This form may be reproduced, but not for sale.

The following are undergraduate courses in Benguet State University that require the BSU-CQE:Course Abbreviation Complete Name of Course CampusAET Associate in Entrepreneurial Technology Main CampusBSA Bachelor of Science in Agriculture Main CampusBSAB Bachelor of Science in Agribusiness Main CampusBSDC Bachelor of Science in Development Communication Main CampusBSAS Bachelor of Science in Applied Statistics Main CampusBSES Bachelor of Science in Environmental Science Main CampusBSIT Bachelor of Science in Information Technology Main CampusBSAEng’g Bachelor of Science in Agricultural Engineering Main CampusBSF Bachelor of Science in Forestry Main CampusBSET Bachelor of Science in Entrepreneurial Technology Main CampusBSHE Bachelor of Science in Home Economics Main CampusBSHRM Bachelor of Science in Hotel and Restaurant Management Main CampusBSND Bachelor of Science in Nutrition and Dietetics Main CampusBSN Bachelor of Science in Nursing Main CampusBEE Bachelor of Elementary Education Main CampusBSE Bachelor of Secondary Education Main CampusBLIS Bachelor of Library and Information Science Main CampusDVM Doctor of Veterinary Medicine Main CampusBEE (Bokod) Bachelor of Elementary Education Bokod CampusBSIE (Bokod) Bachelor of Science in Industrial Education Bokod CampusBSInT (Bokod) Bachelor of Science in Industrial Technology Bokod CampusBEE (Buguias) Bachelor of Elementary Education Buguias CampusBSE (Buguias) Bachelor of Secondary Education Buguias CampusBAT (Buguias) Bachelor in Agricultural Technology Buguias CampusDAT (Buguias) Diploma in Agricultural Technology Buguias Campus1year-Automotive Technology 1year-Automotive Technology Buguias Campus

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Benguet State UniversityOffice of Student Services

La Trinidad, BenguetTelefax: (074) 422 2043

E-mail address: bsu_osatmdu@yahoo.com

This form is for students who have NOT taken the BSU- College Qualifying Examination earlier.If you have already taken the College Qualifying Examination at Benguet State University, the results of your examination are valid

for 2 school years, thus you are advised to visit the Office of Student Affairs- Testing and Materials Development Unit for further instructions.

Instructions in Filling-out this Application FormThis is page 1 of the application form. Be sure to read and understand the instructions before answering page 2. 1. Print or type your entries in CAPITAL LETTERS when filling out page 2. Attach 1 pc. 2x2 ID picture with white background.2. Pay the Testing Fee (PhP 200) at the BSU-Cashier’s Office.3. Submit this Application Form with the following:

a. For currently enrolled high school students: certificate of enrollment from the High School Principal, photocopy of Form 137 (should include first year - third year High School grades with General Weighted Average) duly

signed by the School Principal or School Registrar, and receipt of PhP 200 Testing Fee

b. For high school graduates who have not enrolled in any tertiary level school or vocational school: two photocopies of High School Form 138 (High School Report Card), and receipt of PhP 200 Testing Fee

c. For Transferees: two photocopies of the Certified True Copy of Grades, and receipt of PhP 200 Testing Fee

MODE OF FILING THE APPLICATION:Group Filing

(for currently enrolled high school students) Students submit all requirements to their school

Guidance Counselor, Class Adviser or any appointed representative of the school.

School Personnel / Representative pays the Testing Fee (PhP 200) at the BSU- Cashier’s Office for all their student applicants.

Submit requirements for processing at the OSS- Testing and Materials Development Unit, (Rm. 4), 2nd floor, Student Center Building.

Individual Filing Fill-out the application form. Pay the Testing Fee (PhP 200) at the BSU-Cashier’s Office. Submit Certificate of enrollment from the School Principal and photocopy of

Form 137 (should include first year - third year High School grades with General Weighted Average) duly signed by the School Principal or School Registrar for currently enrolled high school students or 2 Photocopies of High School Form 138 (Report Card) for those who graduated from high school but have not enrolled in any tertiary level school or vocational school or 2 Photocopies of Certified True Copy of Grades for transferees.

*Submit the above requirements to the OSS-Testing and Materials Development Unit (Rm. 4), 2nd floor, Student Center Building.

College Qualifying Examination(BSU-CQE)

Application Form

More at the back

PERSONAL INFORMATION (TYPE OR PRINT CLEARLY)

STATUS OF APPLICANT: (Please check)Currently enrolled as 4th year High School Student ______

High School graduate but has not enrolled in any ______ tertiary level school or vocational school

Transferring to Benguet State University ______

Family Name M M M M M M M M M M M M M M m m M m m M m m

First Name a M M M M M M M M M M M M M M m m M m m M m m

Middle Name M M M M M M M M M M M M M M m m M m m M m m

Gender: ____________ Birth Date: ______-_______-_______ Male /Female Month Day Year

Home Address: __________________________________________________________ Zip code: _______ House No. Sitio Barangay Town/ Municipality Province

(*For currently enrolled high school student)

Name of current school: ____________________________________________________________ Complete Name of High School, specify if Main or Annex/Campus

Address of School: _________________________________________________________________ Write the complete address of school you are attending

(*For high school graduate and transferee)

Last school attended: ______________________________________________________________ Complete Name of School, specify if Main or Annex/Campus

Address of School: _________________________________________________________________ Write the complete address of school

Considering the list of the courses in page 1, write your choice below.

Course applying for:

Course Abbrev. Complete Name of Course Campus (pls. check)

Main

Buguias

Example: BSA Bachelor of Science in Agriculture Bokod

______________________ __________ Applicant’s Signature Date

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STAPLE 1pc. 2x2 ID picture here.

STEPS:1. READ THROUGH THE FORM without filling-out the entries. Be sure you understand

what is being asked for.2. Carefully write down the information needed. Avoid making erasures.

IMPORTANT: COMPLETE THE INFORMATION REQUIRED.