Form 2

10TH PASUC Culture and the Form 2

Arts Festival
Host: Northwestern Mindanao State College
of Science and Technology

ELIGIBILITY FORM
Category: CHORALE COMPETITION_____________________

School/College/University: JH CERILLES STATE COLLEGE____

PERSONAL INFORMATION
Name of Contestant: AÑIEZ, MARC LOUIE JAY B. _____________Date of Birth: Novermber 18, 1999 _________
Height: _5’ 4’’ Weight: 57_kg__
City Address: _PAGADIAN CITY_________________________________ Tel No./Cel No.: 09383673346_________________
Region Address: ZAMBOANGA DEL SUR______________

EDUCATIONAL BACKGROUND
School/College/University Date Graduated
Elementary: _______BAGANIAN ELEMENTARY SCHOOL___ ______March 28, 2011____
Secondary: ______BAGANIAN NATIONAL HIGH SCHOOL__ ______March 30, 2015____
Vocational: ______________________________________ _______________________
If Transferee (Please Specify) ______ _________________________ __ ______________________

CULTURAL PARTICIPATION/INVOLVEMENT (Pls. check)

___ Dance
___ Visual Arts
 Music ___ Special Category
___ Performing Arts

SUBJECT/COURSE INFORMATION DATA

Course: Bachelor of Science in Information Technology________ _________ Year Level: _1st year___ S.Y.: 2018-2019

SUBJECTS BY SEMESTER
1ST Semester Subjects No. of Units Grades 2nd Semester Subjects No. of Units Grades/
On-Going
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Attested by:
___________JEFFRIEL M. LINGOLINGO_________ _________MARK LOUIE JAY B. AÑIEZ_____________
Coach Contestant
(Signature over printed name) (Signature over printed name)
This is to certify that the above mentioned name is a bonafide student of this school and is enrolled for the 1 st and 2nd Semester, for the S.Y. 2012-2013. I further certify that the
above subjects and grades entered therein and all other information are true and correct.
Certified True and Correct:
_________________DANTE S. BAYOCOT____________

School/Colleges/University Seal The School/Colleges/University/Registrar