OFFICE OF THE

GRADUATE SCHOOL
Visayas State University
Visca, Baybay City, Leyte
Email: gs@vsu.edu.ph
Website: vsu.edu.ph

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APPLICATION FOR ADMISSION

To the Applicant: This form shall not be acted upon unless the following documents
and fees are received by the Office of the Graduate School:

1. Official Transcript of Record, in the English language from each college previously attended.
(Original TOR with dry seal).
2. Candid appraisal from former professor and present supervisor (Please use G.S. Form No. 2).
3. Certification of English proficiency by your professor in English (Please use GS Form No. 3)
or TOEFL score. This is required only of applicants from countries where English is not the
medium of instruction and/or not the native language.
4. Application fee of P100 for Filipino citizens or $10 for foreign nationals. (Please remit in check
or money order to Dean of Graduate School).

Name _______________________________ Seeking Admission for_______ 1st Sem. 20____

Contact No.__________________________
_______ 2nd Sem. 20____
______ On-campus
_____ Extramural
________ Summer 20____
Degree Sought:

[ ] M.S. [ ] M.Ed. [ ] M.M. [ ] MLAM [ ] MSLAM [ ] DLAM

[ ] M.Ag.Dev. [ ] Ph.D.

Major Field _____________________________ Minor Field ______________________

A. Sex:

[ ] Male

[ ] Female

Civil Status:

[ ] Single
[ ] Married
[ ] Widow/er

B. Date of Birth: _______________________ Place of Birth: ___________________________

C. Citizenship: __________________E-mail. address_________________________________
D. Present Position/Occupation: __________________________________________________________
E. Agency/Office: _____________________________________________________________
F. Mailing Address:____________________________________________________________
G. Educational Background: ______________________________________________________
Degree (S)
Earned

GPA*

* Grade Point Average/Letter Grade Average

College/University

Year
Obtained

Major Field

Why are you interested in graduate study? ________________________________________

__________________________________________________________________
H. What do you plan to do after getting your graduate degree?
__________________________________________________________________
___________________________________________________________________
I. What are the possible sources of financial support for your graduate study?
SOURCE

PERCENT

Self
Scholarship (specify source)
Assistantship (specify source)
Others: (specify)
J. Personal references: (List 3 names and addresses of people who may have adequate knowledge
about your scholastic competence, personality, and potential for graduate work and whom you
have requested to recommend you.
1. ________________________________________________________________
2. ________________________________________________________________
3. ________________________________________________________________
K. Work Experience (attach additional sheet, if necessary)
Position/Job

Agency/Office

Inclusive Dates

1. Membership in honor and professional organizations

(Please use additional sheet if necessary)
2. Scholarship, honors, prizes and awards.
(Please use additional sheet if necessary)
3. Publication: Give the complete bibliographical information.
(Please use additional sheet if necessary)
4.

Unpublished research papers and/or thesis (Please use additional sheet if necessary)

_____________________________
Signature of Applicant
_____________________________
Date