ࡱ> WZV_ $bjbj,E,E 8FN/N/JFF|||T4=(p=r=r=r=r=r=r=$@B8=|Il=1=^V|p=p=6:<sj:\==0=;C}C8<C|<== =CF f: Republic of the Philippines Mindanao State University-Iligan Institute of Technology SCHOOL OF GRADUATE STUDIES Ground Floor, CSM Bldg., Andres Bonifacio Avenue, Tibanga, 9200 Iligan City Tel.: (063) 221-4050 Local 138 Tel./Fax: (063) 223-2345 Website: http://csm.msuiit.edu.ph/sgs APPLICATION FOR ADMISSION TO GRADUATE PROGRAM Degree Sought: ______________________________ Major: __________________________  1st 2nd Summer Academic Year __________________ INSTRUCTION: Type or print clearly in ink and submit completed application form and other requirements on or before ________________________________ Name: ______________________ _____________________ ____________________ Last First Middle/Maiden _______________ _________________ _____________ Date of Birth Place of Birth Citizenship Contact Information: _______________ _______________ _______________ Mobile Phone No. Landline No. email address/es Address: ________________ ____________________ _________________ ________ No./Street City/Town Province Zip Code Marital Status: Married Widow Single Information on nearest relative (Father / Mother / Spouse if married / Guardian) __________________________ _______________________ _____________ Name Address/ Tel. No. Relationship Education (From secondary to highest university education) Institution Location Date Degree Major Attended Received ______________________ __________________ __________ _________ ________ ______________________ __________________ __________ _________ ________ ______________________ __________________ __________ _________ ________ Scholastic honors or prizes/special trainings: __________________________________ ______________________________________________________________________ Civil Service Eligibility Title of Examination Date Taken Rating __________________________ ____________ _________ Professional Licensure __________________________ ____________ _________ Professional Experience (From latest employment; include teaching and research. Use additional sheet or you may use the back of this sheet, if necessary.) Position Employers Name/Address/Tel. No. Inclusive Dates Remarks ______________ ________________________________ _____________ ________ ______________ ________________________________ _____________ ________ ______________ ________________________________ _____________ ________ List two of your former professors or expert in your field as references. Name & Title Address ___________________________________ ___________________________________ ___________________________________ ___________________________________ I declare that the information supplied in this application and the documentation supporting it is true and complete. I acknowledge that the provision of incorrect information or documentation in relation to my application may result in cancellation of admission or enrolment. If admitted, I agree to abide by the policies, rules and regulation of the èAV IIT School of Graduate Studies. _________________________ ______________ Signature Date Name of Applicant: ______________________________________________________ Degree Sought: _________________________________________________________ Classification: (to be filled up by the Program Coordinator)  REGULAR CONDITIONAL PROBATIONAL  SPECIAL NOT QUALIFIED Remarks: ___________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ RECOMMENDED BY: ___________________________________________________ Program Adviser/Chairman/Graduate Program Coordinator APPROVED: __________________________________ Dean, School of Graduate Studies Notes: Admission Requirements: A bachelors degree, or masters degree, from a recognized institution is required for admission to a masters or doctoral program, respectively. For an applicant to a masters program, an undergraduate Grade-Point-Average (GPA) of 2.00 or better, and for an applicant to a doctoral program, a GPA of 1.75 or better in the masters program; or some evidence of potential ability to pursue a graduate degree, e.g., excellent performance in teaching or research, etc. Evidence of suitable background or its equivalent in the field of study sought. Classification of Graduate Students: Regular - a full-fledged regular graduate student who satisfactorily complies with all the requirements for admission, including those prescribed by the department/college offering the degree. Conditional - an applicant with deficiencies, e.g., prerequisite courses, but satisfies all the basic requirements for admission. The said deficiencies should be satisfied on or before the end of the second semester of the first year of attendance. A student on conditional status should be dismissed from the School of Graduate Studies if he/she fails to earn a GPA of 2.00 or better in the first semester of residence for the masters degree, or a GPA of 1.75 or better for the doctoral degree. Probational - an applicant who fails to earn an undergraduate GPA of 2.00 or better but has proven to be capable to pursue a masters degree, or an applicant who fails to earn a GPA of 1.75 or better in the masters degree but has proven to be capable to pursue doctoral studies. A student on probation should be dismissed from the School of Graduate Studies if he/she fails to earn a GPA of 2.00 or better in the first semester of residence for the masters degree, or a GPA of 1.75 or better for the doctoral degree. Special - an applicant who, in writing, does not intend to pursue a graduate degree but seeks admission to the School of Graduate Studies to register in some courses. Credits earned during the period as a special student are not credited for any degree unless the basic requirements for admission to the degree have been satisfied, approved and recommended by the department/college. Such credits shall not exceed nine (9) units. Not Qualified. An applicant who does not have the necessary preparation to pursue the degree sought. Other Requirements: Submit one copy of this form to the GS Office with the accomplished admission form, two letters of recommendation, one certified true copy each of Transcript of Records and Transfer Credentials/Honorable Dismissal (for non-èAValumnus), one (1) 2 x 2 picture and official receipt of the admission fee. 2 x 2 I.D. 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