FM-AA-AGT-01
Rev. 01
01-Jan-2018
APPLICATION FOR COLLEGE ADMISSION TEST
PANGASINAN STATE UNIVERSITY
FRESHMAN
TRANSFEREE
PLEASE READ BEFORE FILLING UP!
1.
2.
3.
Fill up this form COMPLETELY and CORRECTLY
Submit this form together with 2X2 ID picture with plain background and nametag and Copy of Grades
Wait for the examination permit to be given indicating your schedule of examination.
Last Name
First Name
Middle Name
Complete Address
Date of Birth
Birthplace
Single
Religion
Sex
Male
Married
Civil Status
Female
Others, specify________________
Citizenship
Cellphone Number
Name of Spouse
Contact No. of Spouse
FATHER
MOTHER
(indicate  after the name if deceased)
(indicate  after the name if deceased)
Name
Address
Contact Number
Occupation
Educational Attainment
Guardian’s Name
Relationship w/ Guardian
Guardian’s Address
Contact Number
No. of Children in the family
Senior High School
Year Graduated
General
Average
Last Sem &
School Year
Attended
Year level
and Course
(do not Abbreviate)
1
2
3
4
5 or more
SHS Track and Strand Completed
College/University
(for transferees)
DO NOT FILL UP THIS PORTION
I hereby attest that the above answers are factual about my personal
information which may be checked against original documents and if that
false information could disqualify me for admission. It is understood that my
final acceptance in the college will depend on the requirements and
guidelines imposed by the different colleges relative to the degree program
I intend to take.
Signature:______________________
Date:_________________________
OR No.
Date
Issued by
Date of Examination
Time of Examination
PANGASINAN STATE UNIVERSITY
VISION
MISSION
CORE VALUES
QUALITY POLICY
To become an
ASEAN Premier
State University in
2020.
The Pangasinan State University through
instruction, research, extension and
production commits to develop highly
principled, morally upright innovative and
globally competent individuals capable of
meeting the needs of the industry, public
service and civil society.
Accountability and Transparency
Credibility and Integrity
Competence & Commitment to Achieve
Excellence in Service Delivery
Social & Environmental Responsiveness
Spirituality
The Pangasinan State University shall be recognized
as a ASEAN premier state university that provides
quality education and satisfactory service delivery
through instruction, research, extension and
production.
We shall commit our expertise and resources to
produce professionals who meet the expectations of
the industry and other interested parties in national
and international community.
We shall continuously improve our operations in
response to the changing environment and in support
of the institution’s strategic direction.
FM-AA-AGT-01
Rev. 01
01-Jan-2018
Please put a check mark () on the campus you intend to enroll in and rank 3 courses of your choice to enroll using the numbers 1, 2 and 3
(only) with 1 as the top priority
ALAMINOS CITY CAMPUS
BS Business Administration maj. in Operations Management
Bachelor of Elementary Education
BS Hospitality Management
Bachelor of Secondary Education maj in Mathematics,
Communication Arts - English
BS Information Technology
ASINGAN CAMPUS
BS Business Management maj in Marketing Management
BS Information Technology
Bachelor of Elementary Education maj in General Education
Bachelor of Secondary Education maj in
Mathematics,Communication Arts - English, Physical Science,
TLE
Bachelor of Industrial Technology maj in Automotive Tech.,
Computer and Electronics Tech., Electrical Tech., Food Tech.,
Mechanical Technology, Drafting Tech., Garments Tech.
BAYAMBANG CAMPUS
BS Business Administration
BS Nursing
Bachelor in Public Administration
Bachelor of Elementary Education maj in Enhanced General
Education, Pre-Elementary Education
AB English Language
Bachelor of Secondary Education maj in Biological Science,
Chemistry, Communication Arts - English, Communication Arts
- Filipino, Mathematics, MAPEH, Physical Science, Physics,
Social Studies, TLE
BS Information Technology
BINMALEY CAMPUS
BS Fisheries
BS Criminology
BS Environmental Science
Bachelor of Secondary Education maj in Biological Science,
Fisheries Technology
INFANTA CAMPUS
BS Agriculture
Bachelor of Secondary Education maj in Social Studies
Bachelor of Elementary Education
LINGAYEN CAMPUS
AB Economics
BS Hospitality Management
AB English Language
BS Information Technology
Bachelor in Public Administration
BS Nutrition and Dietetics
BS Biology
BS Computer Science
BS Mathematics maj in Computer and Information Technology, Pure
Math, Statistics
Bachelor of Secondary Education maj in English, Filipino,
Physical Science, Social Studies, TLE
Bachelor of Industrial Technology maj in Automotive Tech,
Ceramics Tech., Civil Tech., Drafting Tech., Electrical
Tech. Electronics Tech., Food Service Management,
Garments, Fashion and Design, Mechanical Tech
Bachelor of Technical Teacher Education maj Automotive Tech,
Ceramics Tech., Civil Tech., Drafting Tech., Electrical Tech.
Electronics Tech., Food Service Management, Garments,
Fashion and Design, Mechanical Tech
BS Business Administration
SAN CARLOS CITY CAMPUS
BS Agriculture
BS Office Administration
BS Business Administration maj in Human Resourse Devt.
Bachelor of Elementary Education
BS Hospitality Management
BS Information Technology
Bachelor in Secondary Education maj in Filipino, Social Studies,TLE
STA. MARIA CAMPUS
Bachelor in Elementary Education maj in Enhanced General
Education
BS Agri-business Management
BS Agriculture
BS Agricultural Engineering
Bachelor of Secondary Education maj in English, Mathematics,TLE
URDANETA CAMPUS
BS Architecture
BS Information Technology
BS Civil Engineering
BS Mathematics maj in Statistics
BS Computer Engineering
AB English Language
BS Electrical Engineering
Bachelor of Elementary Education
BS Mechanical Engineering
Bachelor of Secondary Education maj in Filipino