POLANGUI COMMUNITY COLLEGE
OFFICE OF THE ADMISSION
Alnay, Polangui, Albay
1" X 1" Photo
APPLICATION FORM (recent)
POLANGUI COMMUNITY COLLEGE ENTRANCE TEST
______ Semester; AY 2025 - 2026
Instructions to Students and Parents:
1. THIS FORM IS ONLY FOR APPLICANTS WHO HAVE NOT ENROLLED IN ANY COURSE/SUBJECT BEYOND SENIOR
HIGH SCHOOL.
_____________ ______________
2. CAREFULLY READ THE GENERAL INFORMATION FOR PCC applicants and the GWA Test Result
contents of this form before fillng in the information asked.
3. ONLY CORRECTLY and COMPLETELY FILLED OUT FORMS will be allowed to take
examination. ______________
ADMISSION RESULT
1. Use 1-2 scale, 1 as the most preferred and 2 as the least preferred for your program preference.
Bachelor of Secondary Education Major in:
Filipino Social Studies English
Bachelor of Physical Education (BPED)
Bachelor of Technology & Livelihood Education (BTLED) - Major in Home Economics
Bachelor in Technical-Vocational Teacher Education (BTVTED)
Garments, Fashion & Design Food and Service Management
Bachelor of Science in Enterpreneurship
Bachelor Public Administration (BPA)
Bachelor of Science in Agribusiness (BSAB)
2. PRINT OR TYPE YOUR NAME IN THE FOLLOWING SEQUENCE: Last Name, First Name, Middle Name. Place one letter in each box.
LAST NAME 3. SEX: Male Female
FIRST NAME 4. CITIZENSHIP: Filipino
MIDDLE NAME Non-Filipino
6. PERMANENT HOME ADDRESS 5. RELIGION:
House No./Barangay:
Municipality/Province:
Postal/Zip Code: Tel./Cellphone No.
E-mail Address: LRN:
7. Senior High School graduated or graduating from: SHS Track:
School Address: Expected/Date of graduation:
8. Junior High School/Alternative Learning System (ALS) Completed from:
School Address:
9. Applicant's Date of Birth: - - 10. Civil Status (Check one box only)
Mon. Day Year Single Married Other:
11. Applicant's Place of Birth:
12. Name of Parents:
FATHER'S NAME: MOTHER'S NAME:
Last Name: Maiden Name:
First Name: First Name:
Middle Name: Middle Name:
Occupation: Occupation:
13. Number of children in the family:
14. Monthly family income: (Check one box only)
Less than P 10,000.00 P 15,000.00 - P 20,000.00 P 31,000.00 - P 49,000.00
P 11,000.00 - P 14,000.00 P 21,000.00 - P 30,000.00 Exceeding P 50,000.00
15. Do you have any PHYSICAL DISABILITY or CONDITION that would make it difficult for you to take a regular test? NO YES
(If Yes, please attach Certification of Disability)
16. Is your household a beneficiary of "LISTAHANAN v. 2.0" of DSWD?
NO YES Listahanan 2.0 Household No.
17. What award in sports/arts have you received?
I HEREBY CERTIFY ON MY HONOR THAT I HAVE UNDERSTOOD THE HEREIN INSTRUCTIONS AND THAT ALL THE
INFORMATION HEREIN CONTAINED IS TRUE AND CORRECT.
Signature of Applicant Over Printed Name Signature of Parent/Guardian Over Printed Name