Republic of the Philippines

Municipality of Daraga
DARAGA COMMUNITY COLLEGE
Admission’s Office

DARAGA COMMUNITY COLLEGE ENTRANCE TEST (DCOMCET)

APPLICATION FORM
A.Y. 2025-2026

Programs/Courses Offered:
Preferred Honorific: Put a
o Bachelor of Culture and Arts Education (BCAEd) check (/)
o Bachelor of Elementary Education (BEEd)
o Bachelor of Physical Education (BPEd) Mr. [ ] Ms. [ ]
o Bachelor of Secondary Education (BSEd) 2x2
Mrs. [ ] Mx. [ ]
Major in: colored picture
 English
 Filipino
*Mx. if you wish not to be identified
 Mathematics
by gender.
 Science
 Social Studies
 Values Education
o Bachelor of Technical-Vocational Teacher Education
(BTVTEd) DO NOT FILL OUT THIS PORTION:
Major in:
 Food and Services Management (FSM) Application Form No.: ________________ Date Paid: ____________
 Garments, Fashion and Design (GFD) Application & Testing Fee: ____________ Permit No.: ___________
O.R./M.O. No.: _____________________

Instructions. Kindly fill out the necessary information below. All entries must in capital letters. Write N/A if ‘Not
Applicable’. Avoid erasures.

Preferred Course: _______________________________________________ Major in: ___________________________

I. PERSONAL INFORMATION:

LASTNAME: Check (/) the box below:

FIRST NAME: SEX: Male Female
MIDDLE NAME: CITIZENSHIP: Filipino
DATE OF BIRTH: ______________________ RELIGION: ________________ Foreigner
Year Month Day CIVIL STATUS:
PLACE OF BIRTH: _______________________________________________ Single
HOME ADDRESS: _______________________________________________ Married
PRESENT ADDRESS: Other: (specify)
Street & No.: __________________________________________________ ____________

Barangay: ____________________________________________________
TELEPHONE NO.: ________________
Municipal: ____________________________________________________ MOBILE NO.: ____________________
Province: ____________________________________________________ Are you currently working?
Zip Code: ____________________________________________________ Yes [ ] | No [ ]
EMAIL ADDRESS: _________________
II. EDUCATIONAL ATTAINMENT: (Write the name of your school.)

ELEMENTARY: _______________________________________________ AWARD(S): _____________________

JUNIOR HIGH: _______________________________________________ AWARD(S): ____________________
SENIOR HIGH: _______________________________________________ AWARD(S): ____________________
Public [ ] Private [ ] Private-Catholic [ ] (for Grade 11)
SHS SCHOOL ADDRESS: ______________________________________ Are you currently a scholar?
EXPECTED DATE OF GRADUATION: _______________________________ Yes [ ] | No [ ]
III. FAMILY BACKGROUND:

NAME OF MOTHER: _____________________________________________ OCCUPATION: _______________

NAME OF FATHER: ______________________________________________ OCCUPATION: _______________
NAME OF GUARDIAN: ____________________________________________ OCCUPATION: _______________
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 MONTHLY FAMILY INCOME: Put a check(/)

Below 10,000 16,000 – 20,000 26,000 – 30,000

11,000 – 15,000 21,000 – 25,000 31,000 and above

IV. OTHERS:

In three (3) to five (5) sentences, what made you decide to study at Daraga Community College (DComC)?

__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________.

APPLICANT’S CERTIFICATION

I HEREBY CERTIFY that the information provided in this application form is complete, true and correct to the best of my
knowledge. Then, I HEREBY ACKNOWLEDGE that I have read and understood the Daraga Community College’s (DComC)
privacy notice and agree to it as well. Furthermore, I give my consent to DCOMC to collect, use and process my personal
information. I understand that my consent does not preclude the existence of other criteria for lawful processing of personal
data, and does not waive any of my rights under the Data Privacy Act of 2012 and other applicable laws.

______________________________________ ________________________________________
Applicant’s Signature Over Printed Name Parent/Guardian’s Signature Over Printed Name

Date Signed: ___________________________ Date Signed: ___________________________

REMARKS: (DO NOT FILL OUT THIS PORTION.)

Checked and validated by: Admitted by:

_______________________________________ GLADYS F. VILLAMOR

Admission Staff/Personnel | Date In- charge of Testing and Admission

“Pandayan ng Pangarap”
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