Child Jesus of Prague School

 
Attach 2” x 2” picture
Binangonan, Rizal  
 
 
  APPLICATION FOR ADMISSION
For School year _____________  
Level Applying for ___________  
Thank you for your interest in Child Jesus of Prague School. To assist us in reviewing your application, please complete all section of the application form.
PERSONAL INFORMATION

NAME __________________________________________________________________________________________________________________________________________________________________________    ________________________________  

    LAST NAME GIVEN NAME MIDDLE NAME NICK NAME
ADDRESS _______________________________________________________________________________________________________________________________________________________________________________________________________  
CITY_______________________________________________ PROVINCE_________________________________________________ ZIP CODE ____________________
HOME PHONE No._______________________________ MOBILE No. ________________________________________ RELIGION ______________________________
   
DATE OF BIRTH       /       /           AGE BY JUNE _________________ GENDER ____________   NATIONALITY___________________________
     
MONTH DAY YEAR
     

EDUCATIONAL BACKGROUND
SCHOOL
PREVIOUS LEVEL SCHOOL ATTENDED AWARDS/HONORS RECOGNITION EXTRA, CO- CURRICULAR ACTIVITIES
YEAR

 
FAMILY BACKGROUND
FATHER MOTHER
Name
Address
Home Phone
Mobile Phone
FAMILY BACKGROUND
E-mail Address
Occupation
Name of Company
 
Guardian, if other than father and mother________________________________________________ Relation ___________________________________
Address _________________________________________________________________________ Mobile No. __________________________________

Name of Brothers/Sisters Age Highest Educational Attainment / School

     
     
     
 Do you have a brother/s or sister/s studying in CJPS? _____ No _____Yes (if yes, kindly indicate name grade/year level & section):
Name:_____________________________ Grade/Section: __________ Name:________________________________ Grade/Section: __________
Name:_____________________________ Grade/Section: __________ Name:________________________________ Grade/Section: __________
PERSON ASIDE FROM PARENTS WHOM THE SCHOOL MAY NOTIFY IN CASE OF EMERGENCY):
Name:__________________________________________________ Mobile Phone No. ____________________________

We hereby certify that all the above-mentioned information on this application are true, complete and are made in good faith.
We understand that any falsification of the given information may result to disqualification of the applicant or may be subject
to dismissal.

________________________________ _____________ ______________________________ ____________

Applicant’s signature over printed name Date Parent’s signature over printed name Date

Submission of Required Documents

For Old Students:
______ a) Information Sheet  
For New Students:
______ a) Student Information Sheet
Requirement received by:

______ b) Report Card

______ c) Conforme on Dangerous Drug Policy
______ b) Health Record
 
______ c) Guidance Student Information Sheet
_____________________________
Registrar’s Office
_____________
Date
(for Grade 6 and up) ______ d) PPA Form
______ e) Conforme Form (On withdrawals & Refunds)
______ f) Conforme of Dangerous Drug Policy (Grade 6 up)