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Marco

The document is an admission application form for Eastern Visayas State University filled out by Marco N. Nadongga. It includes personal information, family background, and educational background, along with an examination permit for the course BIndTech AT scheduled for March 1, 2025. The applicant certifies the accuracy of the information provided and consents to the processing of personal data.

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marconadongga12
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11 views1 page

Marco

The document is an admission application form for Eastern Visayas State University filled out by Marco N. Nadongga. It includes personal information, family background, and educational background, along with an examination permit for the course BIndTech AT scheduled for March 1, 2025. The applicant certifies the accuracy of the information provided and consents to the processing of personal data.

Uploaded by

marconadongga12
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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EASTERN VISAYAS STATE UNIVERSITY

Tacloban City
Control No. EVSU-SASO-F-055
Revision No. 2
Title of Form: EVSU Admission Application Form
Date Feb. 24, 2020

M-25-1-13914-8474
Application ID

I. PERSONAL INFORMATION (To be filled in by APPLICANT)


A. Personal Data
Name: NADONGGA MARCO NOYA
Surname First Name Middle Name Name Extension

Sex MALE Civil Status SINGLE Nationality FILIPINO Religion BORN AGAIN CHRISTIAN

Date of Birth (yyyy-mm-dd) 2001-01-20 Place of Birth TACLOBAN CITY Age 24

Permanent Address ZONE SATURN, MAHARLIKA HIGHWAY PAWING


House/Block/Lot No./Street/Subdivision/Village Barangay
PALO LEYTE 6501
Town/City/Municipality Province Zip Code

Phone 09937922113 Email marconadongga12@gmail.com

Do you have any disability? [X] NO [_] Yes, please specify None Height 160 cm. Weight 55 kg.

B. Family Background
Father's Name NADONGGA MARIO OGANIA Age 63
Surname First Name Middle Name Name Extension

Mother's Maiden Name NOYA MILA AMADO Age 63


Surname First Name Middle Name Name Extension

If Married,
N/A N/A N/A Age
provide your spouse's full name
Surname First Name Middle Name Name Extension

Is your family a beneficiary of 4Ps? [X] No [_] Yes, please provide the DSWD Household Number Average Monthly Household Income < 9,100

C. Educational Background
Curriculum: [_] ALS [_] Transferee [X] SENIOR HIGH SCHOOL TRACK:
Schools Attended:
Name of School Year Graduated Average Grade Learner's Reference Number
Grade School PAWING ELEMENTARY SCHOOL 2018 121760140130
High School PAWING NATIONAL HIGH SCHOOL 2022 121760140130
Senior High School PAWING NATIONAL HIGH SCHOOL 2024 121760140130
College

By signing below, I certify that above information are correct and true and that I give my consent to the collection and processing of my personal data in accordance with the needs and requirements of
the university.

MARCO N. NADONGGA
Signature over printed name of the Applicant

II. EXAMINATION PERMIT (To be filled in by OGS)

Application ID:
M-25-1-13914-8474
Name: MARCO N. NADONGGA

Course Applied: BIndTech AT

Date and Time of Examination: Sat, Mar 1, 2025 7:30 AM

Campus / Testing Room MAIN CAMPUS (Tacloban)

Office of the Guidance Services

Downloaded By: MARCO N. NADONGGA , Sun, Mar 9, 2025 1:32 PM

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