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This application is only effective for -

Instruction:
For Admission Concerns, please contact: FB Page: https://www.facebook.com/CSUOAS
(1) Complete the needed details in this application form. 
(2) Save a copy of your application number and examination schedule after filling out the needed details. Note that these are very important during your examination. 
(3) Go to your examination schedule ON TIME. You can never select another date once your schedule is confirmed. 
Please double check your application before saving!
IMPORTANT NOTICE:

      This Entrance Examination is on a 'First Come, First Serve' basis. Each testing schedule has a fixed number of slots.

CONSENT FORM (Please check the box if you agree to collect your data)

      DATA PRIVACY NOTICE. This online application for admission, in line with the Data Privacy Act of 2012, is committed to protecting and securing personal information obtained in the process of performance of its mandate. The personal and other information you provided manually herein will be processed and utilized solely for verification and identification purposes only. Collected personal information will be kept/stored and accessed only by the university and will not be shared with any outside parties unless written consent is secured. By affirming this, I agree to answer the following needed information with utmost willingness to take part in this online application for admission.

STUDENT'S PERSONAL INFORMATION
Undergraduate Application
Preferred Campus:*
First Name*
Middle Name
Last Name*
Suffix Name
(Leave BLANK if NONE or N/A)
Date of Birth* - -
Civil Status*
Sex at Birth*
Sex Orientation, Gender Identity and Expression (SOGIE)*  
Citizenship*
Place of Birth*
Religion*
Ethnicity*
Home Address*
Current Address* Check the checkbox if the Current Address is the same as the Home Address.

Contact Number*
E-mail Address*
What is your preferred hand for activities?
(Such as writing and other manual activities)
*
Are you the first member of the family to enroll in college? *Yes  No
Are you a person with special needs? *Yes  No
Are you a 4P'S Beneficiary?*Yes  No
Are you a Solo Parent?*Yes  No
If solo parent, please fill out below:
  No. of living children: Are you living with your parents?* Yes  No
Circumstances of being a solo parent:
1. A woman who gives birth as a result of rape and other crimes against chastity even without a final conviction of the offender, provided that mother keeps and raises the child
2. Due to death of spouse.
3. Spouse is detained or is serving sentence for a criminal conviction for at least one (1) year.
4. Physical and/or mental incapacity of spouse as certified by a public medical practitioner.
5. Legal separation or de facto separation from spouse for at least one (1) year, as long as he/she is entrusted with the custody of the children.
6. Declaration of nullity or annulment of marriage as decreed by a court or by a church as long as he/she is entrusted with the custody of the children.
7. Unmarried mother/father who has preferred to keep and rear her/his child/children instead of having others care for them or give them up to a welfare institution.
8. Any other person who solely provides parental care and support to a child or children.
9. Any family member who assumes the responsibility of head of family as a result of the death, abandonment, disappearance or prolonged absence of the parents or solo parent.
Do you have other Baccalaureate degree?*Yes  No
Other Baccalaureate degree details:
Name of the Baccalaureate degree last taken:*
School where the degree was taken:*
Address of the school where the degree was taken:*
Inclusive Years:*
Do you intend to transfer here in CSU?
(College Transferee Student?)*
Yes  No
Previous School Details:
Note: This is only for students who are previously enrolled in college and have taken college programs.
Name of the program (College Degree) taken in your previous school:*
Name of your previous school:*
Address of the school:*
Inclusive Years:*
STUDENT'S FAMILY RELATED INFORMATION
Father's Name*


Occupation*


Mother's Name*


Occupation*


Estimated Household Monthly Income*
Guardian's Name (Required for School ID)*
Relationship *
Parent's / Guardian's Contact No.*
Address of the parent/guardian*
Source of Financial Support (You may check more than one)*
Parents
Guardian
Student Assistant
Scholarship  
Others  
If YOU are Employed:
Full-time Employed
Part-time Employed

  • Program Selection
What course would you like to enroll?
1st Priority:*
4th Priority
2nd Priority:*
5th Priority
3rd Priority:*

STUDENT'S OTHER SCHOLASTIC INFORMATION
Which school are you from?*
Inclusive Years:*
Your Elementary School*
SY Graduated:*
Your Secondary School*
SY Graduated:*
For College Admission Only
(Your Senior High School Track)
*
For Admission Office Personnel Only (Just leave this field blank):

Please double check your application before saving!

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Ampayon, Butuan City, Caraga Region, 8600 Philippines
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