Republic of the Philippines
Laguna State Polytechnic University
                                                                 Province of Laguna
                                APPLICATION FOR COLLEGE ENTRANCE TEST
Instructions: READ ADMISSION AND APPLICATION REQUIREMENTS AT THE BACK PAGE
         Fill in all the required information. DO NOT leave an item blank. if item is not applicable, indicate "N/A".
STATUS OF APPLICANT
☑   Freshmen                     ☐   Transferee                        ☐   Returnee                     ☐   Shifter                      ☐   Continuer
PERSONAL INFORMATION
Name                     Beruela                         Joyce Ann Ruby                                               Coronado                                  C
AGE                                DATE OF BIRTH                           SEX                                   CIVIL STATUS                            CITIZENSHIP
                                            2007-11-06
             17                                                         ☐    Male     ☑   Female             ☑     Single                             ☑    Filipino
COMPLETE PERMANENT MAILING ADDRESS
       (HOUSE NUMBER)                   (Street/Subdivision)                     (Barangay)                        (Municipality/City)            (Province)    (Zipcode)
                                Bangkong Kahoy                       Kinabuhayan                         Dolores                                Quezon         4326
MOBILE NUMBER                      TRACK/STRAND                            INTENDED       First Choice: Bachelor of             EMAIL ADDRESS
                                                                            COURSE        Science in Business
                                                                                          Administration
09637061073                                                                                                                  joyceannberuela06@gmail.com
EDUCATIONAL ATTAINMENT
NAME OF SCHOOL                          SCHOOL ADDRESS                              TYPE OF SCHOOL                             YEAR ATTENDED
ELEMENTARY:
Kinabuhayan Elementary School
                                     Brgy. Kinabuhayan, Dolores,
                                     Quezon
                                                                                 ☑    Public       ☐   Private              2013
HIGHSCHOOL:
Sta. Lucia National High School
                                     Brgy. Sta. Lucia, Dolores, Quezon           ☑    Public       ☐   Private              2019
SENIOR HIGH SCHOOL:
Sta. Lucia National High School
                                     Brgy. Sta. Lucia, Dolores, Quezon           ☑    Public       ☐   Private              2023
COLLEGE: (For Transferee)
                                                                                    ☐     Public                                From:
                                                                                                                                To:
                                                                                    ☐     Private
Course                                  REASON FOR TRANSFERRING:
RAW SCORE:                   GWA: 91                           GUIDANCE COUNSELOR/GUIDANCE PERSONNEL:                                        DATE FILED:
                                                                                                                                             February 12, 2025
LRN: 108681130001                                              SIGNATURE OF THE APPLICANT:
 Application Number: 174735                                     LSPU ENTRANCE TEST PERMIT
To be filled-out by applicant
 Applicant's Name: Joyce Ann Ruby Coronado Beruela
 Intended Course: Bachelor of Science in Business Administration
 SCHEDULE OF EXAMINATION
 Date: ____________         Approved:
 Time: ____________                               ___________________________________
 Room No: ____________                              Examiner's/Proctor's Signature