Republic of the Philippines
Bangsamoro Autonomous Region in Muslim Mindanao
GANI L. ABPI COLLEGE INCORPORATED
Buayan, Datu Piang, Maguindanao Del Sur
GLACI - CMI 2024-2025
APPLICATION FOR ADMISSION
2x2
Date _______________ Picture
Semester/Summer _____
SY __________
Name ______________________________________________________ Sex________ Civil Status ____________
Last Name First Name M.I.
Mailing Address ___________________________________________________________ Tel. Number ___________
City Address ____________________________________________________________ Cell. Number __________
Name of Landlady/Landlord _________________________________________________________________________
Citizenship ______________________________________________ Religion____________________________
Date of Birth ______________________________________________ Place of Birth _______________________
Name of Parents ___________________________________________________________________________________
Secondary School Graduated __________________________________________ Address _______________________________
Awards/Honors Received _____________________________________________ Gen. Ave. Rating ________________________
College(s) attended before GLACI.
Name of School Address Course Enrolled Semester/Year Reason for Leaving
________________________ _____________________ __ ___________________ _____________ _________________
________________________ _____________________ __ ___________________ _____________ _________________
________________________ _____________________ __ ___________________ _____________ _________________
________________________ _____________________ __ ___________________ _____________ _________________
Special Skills __________________________________________________________
Organization(s) Affiliated Positions Held Term
_____________________________________ _________________________ __________________
_____________________________________ _________________________ __________________
_____________________________________ _________________________ __________________
_____________________________________ _________________________ __________________
Have you ever been disciplined for any infraction or violation of school rules and regulations?
[ ] Yes, specify ________________________ [ ] No
Do you promise not to take any prohibited drugs as long as you are connected with GLACI?
[ ] Yes [ ] No
Do you promise not to participate in any unlawful act or any illegal assembly?
[ ] Yes [ ] No
STUDENT’S PLEDGE
I promise to faithfully perform my duties and responsibilities as a student in this college and abide by its policies,
rules and regulations, and certify that all statements and information are true and correct.
Attested by: _____________________
Relationship: ____________________
________________________________
Student’s Signature
*************************************************************************************
List of requirements submitted:
[ ] Form 138A/HS Card [ ] PSA Birth Certificate
[ ] Certificate for Transfer Credential [ ] Pre-registration Form
[ ] Good Moral Certificate [ ] Marriage Contract, if married
[ ] 2 x 2 Picture [ ] others, specify ___________________
Action Taken: [ ] Admitted
[ ] Not Admitted
[ ] Admitted on Probation
Remarks: [ ] admitted but has to meet deficiencies
________ Major pre-requisites (_________ units)
________ Others, pls. specify ________________
[ ] enrolled temporarily pending submission of credentials/other
admission requirements for the program applied for (waiver must be
submitted to the College Registrar's Office.
____________________________
MELODY ARANDELA-AMBANGAN, RSW, MSSW JOHN RAY D. GARCIA, LPT
College Dean Admission Supervising Head
