SOUTHERN LUZON STATE UNIVERSITY
College Application Document Checklist
3
EXAMINEE NO.:________________ * DATE OF APPLICATION:________________
2025-01-08
* NAME:_____________________________________________________________________
Jasline Maralit *CONTACT NUMBER: ___________________
Do you have any PHYSICAL DISABILITY OR CONDITION that requires special attention? * No. of siblings below 21 years old:
No Yes Pls. specify:__________________________ ____________________________
How many of your siblings have completed a college degree? What is your sibling rank?(1st born, 2nd born, 3rd born, etc.)
SUBMITTED DOCUMENTS /check the appropriate box:
● 2x2 Picture with nametag and white background Yes No
● Academic Records *General Average (GWA):___________ *Academic Track:______________
Grade 11 Card Grade 12 Card Copy of Grades/TOR ALS Old Curriculum
*Name of Last School Attended:________________________________ *School Year:____________ Private Public
*First Choice SLSU Campus:_______________________________ *Second Choice SLSU Campus:_______________________________
❖ First Choice Program: ❖ First Choice Program:
* *
❖ Second Choice Program: ❖ Second Choice Program:
* *
Certificate of Income for Both Parent/s or Guardian/s (check your supporting documents):
*Father's/Guardian's Occupation: ____________________ *Mother's/Guardian's Occupation: ____________________
*Monthly Income: _________________________________ *Monthly Income: _________________________________
________4Ps Certification from MSWD/DSWD ________4Ps Certification from MSWD/DSWD
________Certification from IP Chieftain (Mga Katutubo) ________Certification from IP Chieftain (Mga Katutubo)
________Certification from DILG/Office of the Presidential ________Certification from DILG/Office of the Presidential
Adviser on the Peace Process Adviser on the Peace Process
________BIR Form 2316 ________BIR Form 2316
________Certificate of income from Employer/HR ________Certificate of income from Employer/HR
________BIR Form 1701A ________BIR Form 1701A
________Overseas Employment Contract ________Overseas Employment Contract
________Death Certificate ________Death Certificate
________Solo Parent Certification from DSWD/MSWD ________Solo Parent Certification from DSWD/MSWD
________PWD Certifcate from MSWD/DSWD ________PWD Certifcate from MSWD/DSWD
________Notarized Sworn Statement from Atty ________Notarized Sworn Statement from Atty
Additional Requirements (for GIDA, Athletes, CAF Delegates):
I hereby certify to the best of my knowledge that the foregoing data are true and correct.
*Applicant's Signature over Printed Name *Date Signed
FOR SLSU STUDENT ADMISSION OFFICE/PERSONNEL ONLY:
GWA:__________ Eco:__________ Sibling:__________ School:__________ Special Skill:__________
REMARK:
ASSESSED BY:
Signature over Printed Name Date signed
