Republic of the Philippines

CEBU TECHNOLOGICAL UNIVERSITY

CTU-Main Campus
Corner M. J. Cuenco Avenue and R. Palma St.,Cebu City

REGISTRATION FORM
STUDENT PERSONAL DATA: Date: _______________________

(Last Name) (First Name) (Middle Name)

HomeAddress:
Congressional District: Telephoneno.
Gender: [ ]Male [ ]Female Birthday: / / Birthplace: Age:
Citizenship: Religion: Civil Status: [ ]Single [ ]Married [ ]Separated [ ]Widower
Father's Name: Occupation:
Mother's Name: Occupation:
Guardian'sName: Contact Number::
Educational Background Nameof School Academic Year Honors Received
Elementary
HighSchool
College
Enrolment Documents Submitted:
[ ] Form 138 [ ] Birth Certificate [ ] Certificate of Good Moral Character [ ] Certificate of Transfer Credentials & TOR [ ] Medical Certificate

“I hereby certify that all entries are true and correct. I do solemnly swear to abide with the laws, policies, rules, and
regulations set forth by the College.”

Student’s Signature over Printed Name

STUDENT LOAD:
ID Number: Course: Major: Year Level:
School Year: Semester: [ ]1st [ ] 2nd [ ] Summer Enrolment Status: [ ] Regular [ ] Irregular
Student Status: [ ] New [ ] Transferee [ ] Returnee [ ] Cross Enrollee BLOCK SECTION:
MIS Code Course Code Descriptive Title Time Days Room Units

EVALUATED BY:
College Dean/ Enrollment Committee: Date: Total Units:

APPROVED BY:
1.MEDICAL CLINIC 3.EDP OFFICE (Issuance of ID number 6.EDP OFFICE (Encoding of Student
(Physical Examination) and student personal data entry) Load & releasing of Cert. of Registration)

School Physician/ Nurse System’s Operator System’s Operator

2.NSTP 4.CASHIER (Payment of entrance fee) 7.REGISTRAR’S OFFICE (Submission

(Enlistment for those who will be taking OR#: of registration form with enrolment
CWTS or ROTC) Date: credentials)
Signature:

Coordinator PTA FEES (Payment for

membership/special project/group University Registrar
STUDENT AFFAIRS OFFICE insurance)
(Scholarship grants and issuances of OR#:
handbook) Date:
Signature:
5.LIBRARY

Dean
University Librarian