UNIVERSITY OF ST.

LA SALLE - BACOLOD
THEO PLAN A PROGRAM
APPLICATION FORM
Please type or Print legibly
surname given name middle name nickname
NAME:

ADDRESS:

Provincial Address (if you're only staying in a boarding house in Bacolod)

Gende
Course, Yr & Sec ID No r
Blood
Birthday Tuition Category Type
Religion Mobile Nos.
Home
Baptismal Date PhoneNo
Baptismal Place Email Address
High School you graduated
from:
Parish Name & Address
Current RS Teacher current RS Schedule

Father's Name Dad's contact No.

Dad's Work & Business Address
Mom's contact
Mother's Name no.
Mom's Work & Business Address
Guardian's Name Contact No
Guardian's Work & Business Address

What are your reasons for joining the Theo Plan A Program:

PASTE YOUR
RECENT 2X2
What are the talents which you can share with the Theo Plan A COLORED
Program: ID PICTURE
HERE

THEO PLAN A COMMITMENT

I, __________________________, am applying to be a volunteer catechist of the University of St La Salle
through the Theo Plan A Program. I am willing to abide with the policies of the Program and I understand that
in lieu of my attendance to my RS classes, as a volunteer I have to set aside 1 hour of my vacant period every
week to go and teach catechism to the public elementary school where I will be assigned and I promise that I
will faithfully adhere to the obligations and regulations of the Theo Plan A Volunteer. I commit myself to Christian
service.

Conforme: Approved by:

a
(signature over printed name of applicant) (Theo Plan A Moderator) b
c
d
(signature over printed name of applicants' parents or guardian)
Note: Bring this form during interview.
other documents to bring:
1. Evaluation Form: fully accomplished by your RS1 or RS2 Professor and sealed in an envelope
2. Baptismal Certificate