Republic of the Philippines
CENTRAL MINDANAO UNIVERSITY
University Town, Musuan, Bukidnon
OFFICE OF ADMISSIONS, SCHOLARSHIPS, AND PLACEMENT
APPLICATION FORM
Central Mindanao University College Admission Test (CMUCAT)
Testing Fee: ₱200.00 for 2nd Time Takers/transferees (Pay at the CMU Cashier’s Office) Application No.: CMUCAT-2025033154Rq59vlqq
O.R. No: __________________________________________ Room No.:
________________________________
A. APPLICANT’S PROFILE
NAME: COLIS CYMON JOSHUA SORILLO
(Family Name) (First Name) (Middle Name)
Attach in this box
a recent 1x1 ID
BIRTH DATE 2004-03-14 picture of the AGE 2004-03-14
BIRTH PLACE KIBAWE BUKIDNON applicant RELIGION CATHOLIC
Eldest 2nd 3rd Others, specify
BIRTH RANK SEX ☑ MALE ☐ FEMALE
__________________
CITIZENSHIP ☑ FILIPINO ☐ FOREIGN ☐ DUAL If Foreign/Dual Citizen, specify ________________
Member of Indigenous Peoples Group? ☐ YES ☑ NO If Yes, specify IPG ________________
A. EDUCATION LRN 126325100023
Year of Graduation from Grade 6/Elementary School’s
2016-03-30 BARONGCOT ELEMENTARY SCHOOL
School? Name
School’s
Year of Graduation from Junior High School? 2021-05-27 DANGCAGAN NATIONAL HIGH SCHOOL
Name
SENIOR HIGHSCHOOL NAME (Do Not
Abbreviate)
SHS Track/
Expected Year/ Year of SHS Graduation 2023-06-11 STEM
Strand
ADDRESS (City/Town,
Purok 1-A población, dangcagan, buidnon Region X
Province)
For Transferees, HEI Name ACLC College of bukidnon
HEI Address (City/Town, Province) Sayre highway, Hagkol,Valencia CIty Region X
Bachelor of Science in
Degree Program Yr Level 2024-2025
Information technology
B. COURSE/S YOU INTEND TO TAKE AT CMU C. SENIOR HIGH SCHOOL GRADE
CHOSEN COURSE/S ENGLISH 84
FIRST CHOICE BACHELOR OF SCIENCE IN INFORMATION TECHNOLOGY MATH 84
SECOND CHOICE BACHELOR OF ARTS IN HISTORY SCIENCE 86
D. PERMANENT HOME ADDRESS
Number and Street P-3 BAROINGCOT ELEMENTARY SCHOOL Barangay BARONGCOT
City/Municipality DANGCAGAN Province BUKIDNON
Region REGION X (NORTHERN MINDANAO) Postal/Zip Code 3424
E. CONTACT INFORMATION
Telephone Number Cellphone Number 09557681440 E-mail Address
[email protected] F. OTHER INFORMATION
Are you a child of a CMU Faculty or Employee? ☐YES ☑NO Are you a PWD? YES NO
If Yes, from what college/office If Yes, specify _________________________________________
Employment Status ☑ Permanent ☐ Temporary ☐ Others Are you an Orphan? Self-supporting?
If Other(s), please specify Are you a Single Parent? Senior Citizen? Rebel Returnee?
G. SOCIO-ECONOMIC DATA Are you from a Single Parent household? YES NO Please fill out the appropriate information need.
Father’s Name Mother’s Maiden Name Legal Guardian (Other than parents)
Full name SIM P. COLIS ANA LIZA S. COLIS
Citizenship
Highest Educational Attainment GRADE 3 COLLEGE GRADUATE BEED
Occupation HOUSEHUSBAND TEACHER
Employer
Gross Household Income from regular sources ☑below 5,000 ☐5,000-10,000 ☐10,001-25,000 ☐25,001-50,000 ☐50,001-100,000
☐100,001-150,000 ☐150,001-200,000 ☐200,001-250,000 ☐above 250,000
H. APPLICANT’S SIGNATURE
I hereby certify under the pain of perjury that all my statements above are true and correct to the best of my knowledge. I consent the Office of
CMU-F-1-ASP-003 03 OCTOBER 2024 Rev. 2 Page 1 of
1
Republic of the Philippines
CENTRAL MINDANAO UNIVERSITY
University Town, Musuan, Bukidnon
OFFICE OF ADMISSIONS, SCHOLARSHIPS, AND PLACEMENT
Admissions, Scholarships, and Placement (OASP) may utilize my information in posting of the result and other legal purposes.
________________Cymon Joshua S. Colis___________________ ______________________
Signature Over Printed Name Date
I. SCHOOL CERTIFICATION (To be filled by the School Personnel e.g. J. ACTION TAKEN (To be filled out by the CMUAT Board)
Principal, Guidance In-Charge, Class Adviser)
APPROVED DISAPPROVED PENDING
I hereby certify that Cymon Joshua S. Colis is a bona fide student of
BARONGCOT ELEMENTARY SCHOOL for the SY_________________. Remarks: ________________________________________________
______________________________________
Name and Signature of School Representative _____________________________________
Designation: _____________________________ Date: ________________ CMUAT BOARD
Date __________________________
Central Mindanao University College Admission Test (CMUCAT) PERMIT
Attach in this box a O.R. No. Application Number CMUCAT- Date Filed 2025-03-31
recent 1x1 ID 2025033154Rq59vlqq
picture of the Name of Examinee Cymon Joshua S. Colis LRN 126325100023
applicant Date of Test 2025-04-27 Time 1:30PM
Place of Test College of Education Room No. 1
Signature CMUAT Board
CMU-F-1-ASP-003 03 OCTOBER 2024 Rev. 2 Page 1 of
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