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Republic of the Philippines

DEPARTMENT OF EDUCATION
Cordillera Administrative Region
Schools Division of Benguet
Cordillera Regional Science High School ATTACH ID HERE
Wangal, La Trinidad, Benguet
Tel. Fax (074) 422-5662 1.5 x 1.5
SchooI lD No.305140

APPLICATION FOR ADMISSION

Please print legibly all information required. Place X marks in appropriate blanks.

PERSONAL DATA

FAMILY NAME:

FIRST NAME:

MIDDLE NAME:

PRESENT ADDRESS: _________________________________________________________________________________________________

PROVINCIAL ADDRESS: ______________________________________________________________________________________________

DATE OF BIRTH: ________________________________________ AGE: __________


MALE:____ FEMALE:____
CITIZENSHIP: ___________________________________

SCHOOL PRESENTLY ENROLLED IN, and SCHOOL ADDRESS:


________________________________________________________________________________________________________________

EMAIL ADDRESS: _______________________________________________

PARENTS PROFILE

FATHERS NAME: MOTHERS NAME: (Maiden name)

Last Name First Name M.I. Last Name First Name M.I.
PRESENT ADDRESS: PRESENT ADDRESS:

PROVINCIAL ADDRESS: PROVINCIAL ADDRESS:

WORK ADDRESS: WORK ADDRESS:

TELEPHONE NUMBER: TELEPHONE NUMBER:

MOBILE PHONE: MOBILE PHONE:

I (we) certify that all information on this application is accurate and complete.

_________________________________ __________________________________
Signature over printed name of STUDENT Signature over printed name of PARENT

ACKNOWLEDGEMENT RECEIPT
Date:________________________
Attach ID here
1.5x1.5 Received from ___________________________________________________________________

the sum of Two Hundred Pesos only (P200.00) as payment for CRSHS examination fee.

___________________________________________
Signature over Printed Name

This form can be duplicated.


THE CORDILLERA REGIONAL SCIENCE HIGH SCHOOL

Dear Parents/Guardians,

Thank you for considering Cordillera Regional Science High School. This form contains the admission
process of our institution and we are more than willing to assist you in the process. For your queries and
more information, please contact the school at telephone number: 422-5662.

The CRSHS Administration and Staff


The Cordillera Regional Science High
School is one of the leading academic institutions in
the Cordillera Region. Since its establishment in Step 3: Second and Third Screening
1994, their achievements in both curricular and co-
curricular activities are unrivaled. For years, the Qualified applicants for this stage are those
school strived for the attainment of its mission to applicants who passed the First Screening test and
serve as a wellspring of excellent Science and should have grades of 80% and above in all subjects
Mathematics-oriented education and to produce for the 1st and 2nd grading.
competent, inventive, and dynamic students.
With its sophisticated instructional The students-applicants should bring with them TWO
materials, technology-rich and harmonious (2) pieces of NUMBER 2 MONGOL pencils. The
environment, it has fashioned leaders and student is permitted to take his/her snack while the
professionals who are successful in their own test is conducted.
endeavors. More than academics, the school offers
culturally-enriched and life skills education. In The second stage is the proficiency test in English,
recognition of the school’s unceasing commitment to Science and Mathematics followed by an interview
excellence, the Department of Education and with the student and his/her parents.
numerous institutions bestowed awards and After the test, the third screening which is an
appreciations. interview of the student and the parent by the CRSHS
Admission Committee will be conducted. The
ADMISSION REQUIREMENTS: interview shall be rated in accordance to a prepared
 Completely filled out Application Form to rubric and shall be an integral part of the score
be submitted on or before 5:00 p.m. on obtained by the student. The student will be notified
December 8, 2017 of the results of the second and third screening
 Photocopy of Form 138E bearing the grades through a letter addressed to his/her respective
for the 1st Grading Period elementary school.
 No grades lower than 80 in all learning areas
in Grade VI THE FINAL SCORE
 PHP 200.00 application fee (non-
refundable) The following shall be the basis for the computation
of the student-applicants final score:
APPLICATION PROCESS:
90% from the PROFICIENCY TEST
Step 1: Submission of Requirements 10% from the INTERVIEW WITH STUDENT
APPLICANT AND HIS/HER PARENT
The Application Form and a photocopy of FORM
138E should be submitted to the school not later than The qualified incoming Grade 7 students should have
the day before the scheduled first screening test. grades of 80% and above in all grading period in
Grade VI to be able to enroll.
Step 2: First Screening
SUMMER ENCAMPMENT FOR
The first stage is the administration of a standardized NEW STUDENTS
mental ability and aptitude test to be administered by
a licensed psychologist. The student-applicant should The qualified incoming Grade 7 shall also be
belong to the top 40% of the total examinees in order required to join the encampment in May 2018. This
to advance to the second stage. encampment was conceptualized to let the incoming
students gain a grasp of some activities in store for
The tests schedule and venue of examination will be
posted by the school a day before the test. Student- them in the different subject areas and for them to
applicants are required to bring TWO (2) pieces of bond with each other as they start a new school year
NUMBER 2 MONGOL PENCILS. in a new environment. It will also provide a ‘hands
on, minds on”, experience in all subject areas where
Results will be posted on the bulletin board and will the students can develop their social learning
be sent to the student’s respective elementary school capabilities by exposing them to varied fun activities
after 10 working days.
and to enhance experiential learning among students.

For the First Screening: For the Second and Third Screening:
 Bring 2 pieces #2 Mongol pencil  Bring 2 pieces #2 Mongol pencil, and snack
 Applicants should be at the testing area before
 First batch should be at the testing 7:30 a.m.
area at 8:00 a.m. while the second  While the applicants are having their test, their
batch should be at the testing area parents will be interviewed at the CRSHS Library.
at 9:00 a.m.  The applicants will be interviewed just after their
test.