Republic of the Philippines Cebu Normal University Osmeña Blvd. Cebu City, 6000 Philippines Website: www.cnu.edu.ph COLLEGE ONLINE APPLICANT PROFILE SHEET Reminders (for New Students and transferees) Date of Application: _____________________ 1. Write NA/none for not applicable inquiry Note: CNU is not yet accepting students outside Philippines or residing/working 2. Do not leave any spaces blank/unanswered abroad. If in the event that you failed to disclose this information and enrolled yourself even though you are outside the country, subjects taken will not be credited and no refund of any payment made. PERSONAL DATA Name Recent 2x2 colored picture SURNAME FIRSTNAME MIDDLE NAME 2x2 latest picture with with name and signature Degree Program Applied For: name and signature (scanned or picture copy) Campus (Main/Medellin/Balamban): ____________________________ AY/SY: Email Address: Facebook Account: Home Address: Zip Code of Home Address: Home Phone: __________________ Mobile phone: Present Address (boarding house/relative’s house and etc.) Zip Code of Present Address: Religion: ____________ Height: ________ Weight: __________Sex: __________Blood Type: Civil Status (put a check): Single Married Widowed Separated Live-in Annulled Single Parent Citizenship: ________________ Age: Date of Birth: ___________________ Place of Birth: Person to be contacted in case of emergency: His/her address: Telephone #/ Mobile phone #: If married, write Maiden Name (for ladies): Name of Spouse: ____________________________________________ Occupation: SURNAME FIRSTNAME MIDDLE NAME Contact Number: Father’s Name: ______________________________________________ Occupation: SURNAME FIRSTNAME MIDDLE NAME Address: ___________________________________________________ Contact number: Mother’s Name: _____________________________________________ Occupation: SURNAME FIRSTNAME MIDDLE NAME Address: ___________________________________________________ Contact number: EDUCATIONAL BACKGROUND Name of Senior High School Currently Attending: _______________________________________ GPA: _______LRN: ________________Track: ______________Strand: _____________________ Year Graduated: __________ School Address: ___________________________ Zip Code: ______ Sector, please check one: If private school, please check one: _____ Public _____ Sectarian _____ Private _____ Non-Sectarian Academic Honors Received: ______________________ Name of College/University (if transferee/2nd courser): _________________________________________ Course: __________________________SY: ____________Year Graduated (2ND Courser): _____ I hereby attest that the information provided herewith are true and correct. Further, I hereby authorize Cebu Normal University to utilize the data for admission purposes and whatever legal purposes these may serve. ________________________________________ PRINTED NAME AND SIGNATURE OF APPLICANT Registration No. 52Q18778 Certification Date: 6 August 2018 Recertification due date: 24 January 2021 For verification of the certificate please access www.globalgroup.net (Certification check and type the registration number) .