APPLICATION FOR ADMISSION

SILLIMAN UNIVERSITY
Attach
Dumaguete City, Philippines 6200 latest picture
2” X 2”
Please fully accomplish this form and send to the ADMISSIONS OFFICER,
Silliman University, Dumaguete City 6200, Philippines

Villegas Winston Galicano Faburada

Name:________________________________________________________________________________________
(Last) (First) (Middle name)

94
High School General Average: __________________________ (general admission requirement is at least 80%)
Purok Atis, Balugo, Dumaguete City
Home Address: ________________________________________ 09088981278
Tel No./Mobile: ______________________
Purok Atis, Balugo, Dumaguete
Dumaguete Address: ____________________________________ City 09088981278
Tel No./Mobile: ______________________
10 December 2001, Dumaguete City
Date and Place of Birth: __________________________________ winstonfvillegas@su.edu.ph
E-mail address: ______________________
Single
Marital Status: _______________________________ Filipino
Citizenship: _______________________________________
Roman Catholic
Religious Affiliation: ___________________________________________ O
Blood Type _______ Male
Gender: _______
If foreigner, state status of admission: □ Immigrant □ Non-immigrant □ Balikbayan

Note: If foreigner, accomplish separate “Application for Study” permit with the Adviser to International Students at
the Office of Student Services located at the ground floor at the Oriental Hall.

List of schools you attended (from elementary up to college, if applicable)

Name Location Certificate/ Dates of Year
St. Louis School of Degree Earned Attendance Graduated
Don Bosco Calindagan, Dumaguete City Katunayan Certificate 2014
June 2008-March 2014
_____________________________________________________________________________________________
SLS-DB Calindagan, Dumaguete City Katunayan Certificate June 2014-April 2018
_____________________________________________________________________________________________ 2018
SUSHS Hibbard Ave., Dumaguete City Katibayan Certificate June 2018-March 2020
_____________________________________________________________________________________________ 2020
Silliman University Hibbard Ave., Dumaguete City Bachelor of Arts in Political August 2020-May 2024
_____________________________________________________________________________________________ 2024
Science
_____________________________________________________________________________________________
JD
Course program you wish to earn in Silliman:( )Degree _______________________________________________
( )Certificate Course ______________________________________
1st Sem 2024-2025
Earliest date you wish to enter Silliman: ____________________________________________________________
Condition of health (check one): ( ) Excellent ( ) Good ( ) Fair
For Person with Disability(PWD), please state nature of disability:________________________________________
Indigenous Person: ( )Yes ( )No
Single/Solo Parent: ( )Yes ( )No
Who/What influenced you to study in Silliman University?
□ Parents □ Faculty/Staff □ Social Media □ Friend
□ Alumni □ Website □ TV/Radio □ School of origin
□ Invitation Letter □ Posters & Brochures □ School Campaign

Please describe below other factors: ________________________________________________________________

Father Mother

Name of parents
Winston Christian A. Villegas Hazel F. Villegas
(as indicated in your birth certificate) :

Highest Degree Attended: Juris Doctor : Juris Doctor

School Attended: Foundation University : Foundation University
Year Graduated: 2004 : 2005
Occupation: Government Employee : Judge
Optional: ANNUAL INCOME(for those who are applying scholarship)

Father Mother

Annual Income: ( Please check appropriate box )

 P 62,000 & below  P 62,000 & below

 P 62,100 – 101,000  P 62,100 – 101,000
 P 101,100 – 151,000  P 101,100 – 151,000
 P 151,100 – 191,000  P 151,100 – 191,000
 P 191,100 – 231,000  P 191,100 – 231,000
 P 231,100 – 271,000  P 231,100 – 271,000
 P 271,100 – 301,000  P 271,100 – 301,000
 P 301,100 – 351,000  P 301,100 – 351,000
 P 351,100 – 391,000  P 351,100 – 391,000
 P 391,100 – 431,000  P 391,100 – 431,000
 P 431,100 – 471,000  P 431,100 – 471,000
 P 471,100 – 501,000  P 471,100 – 501,000
 P 501,100 – 551,000  P 501,100 – 551,000
 P 551,100 – 591,000  P 551,100 – 591,000
 P 591,100 – 603,000  P 591,100 – 603,000
 P 603,100 – and above  P 603,100 – and above

Purok Atis, Balugo, Dumaguete City; 639088913978

Address and Contact Number of Parents: ____________________________________________________________
Hazel F. Villegas, Balugo, Dumaguete City; 639088913978
Name, Address and Contact Number of Guardian : ____________________________________________________
________________________________________ Judge
______ Occupation: ________________________________
Who is responsible for the payment of your tuition and school fees? (Name of and relationship to re-
person/sponsor.)
Hazel F. Villegas-Mother
_____________________________________________________________________________________________
Will you live in the dormitory? If yes, what type of accommodation?
( ) Yes ( ) No ( ) Regular ( ) Cooperative
If no, where will you stay? (Specify name and address)
Name of Relative or Friend Name of Lodging House
Winston Christian A. Villeges- Purok Atis, Balugo,
___________________________________________ ______________________________________________
Dumaguete City
___________________________________________ ______________________________________________

The above information is true and correct. Once admitted in Silliman University, I hereby accept and abide
by the rules and regulations of the University, including the submission of myself to random drug testing.

5 Aug 2024 Winston Galicano F. Villegas

_______________ __________________________________
Date Signature of Student Over Printed Name

FOR THE PARENT OR GUARDIAN

Hazel F. Villegas
I, _____________________________________________ Winston Galicano F. Villegas
of____________________________________________
(Parent / Guardian) (Student)
hereby approve the application of my son/daughter/ward, for admission to Silliman University and hereby accept
and agree to abide by the rules and regulations of the University and consent to the random drug testing of my child
as may be provided for by the University.

5 Aug 2024 Hazel F. Villegas

_______________ __________________________________________
Date Signature of Parent or Guardian Over Printed Name