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Application Form For SY2018 2019 1 PDF
Application Form For SY2018 2019 1 PDF
PERSONAL DATA
Level Applied For:
Primary Nursery 1 Nursery 2 Kinder
Science, Technology, Engineering and Mathematics (STEM) Humanities and Social Studies (HUMSS)
Senior High School
Accountancy, Business and Management (ABM) General Academics Strand (GAS)
FAMILY BACKGROUND
FATHER (Write D for deceased) MOTHER
Name
Age
Citizenship
Home Address
Tel. No. / Mobile No.
Occupation
E-mail Address
Employer
Business / Office Address
Telephone Number/s
Educational Attainment
Last School Attended
BROTHERS AND SISTERS (Please list siblings from eldest to youngest. Attach additional sheet if necessary.)
HIGHEST
CIVIL YEAR LEVEL/
NAME AGE SCHOOL EDUCATIONAL
STATUS YR. GRADUATED
ATTAINMENT
_________________________________________________________________
Please fill-in the blanks and mark boxes.
Combined annual income of parents Residence
100,000 and below 401,000 – 500,000 Owned
101,000 – 200,000 501,000 – 600,000 Rented
201,000 – 300,000 601,000 – 700,000 Living with relatives
301,000 – 400,000 701,000 and above Others: _________
EDUCATIONAL BACKGROUND
LEVEL NAME & ADDRESS OF SCHOOL YEAR ATTENDED HONORS/AWARDS
GRADE SCHOOL
Nursery
Kinder
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
JUNIOR HIGH SCHOOL
Grade 7
Grade 8
Grade 9
Grade 10
SENIOR HIGH SCHOOL
Grade 11
Grade 12
SEMESTER and
NAME & ADDRESS OF
COLLEGIATE COURSE SCHOOL YEAR HONORS/AWARDS
COLLEGE/UNIVERSITY
ATTENDED
Year I
Year II
Year III
Year IV
HEALTH
Any physical or learning disability or anything that may influence future academic performance? (e.g. asthma, heart condition, hearing
and reading difficulties, allergies, students with special needs, etc.) Including Psychological Condition.
Where did you first find out about De La Salle Lipa? (Please check as many as applicable)
Career Orientation Family
Posters Friends
Internet Advertisements
Referred by: Others, please specify _________________________
(Name of DLSL employee) cdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcdjcd
VERIFICATION
I certify that the information given herein is correct and complete. Falsification or withholding of information requested in this form
will automatically nullify my application and/or subject me to dismissal, even if already admitted.
_____________________________________ _____________________________________
Full name and Signature of Applicant Date
_____________________________________ _____________________________________
Full name and Signature of Parents/Guardian Date
_________________________________________________________________
*To be filled out by the IATO Staff
DE LA SALLE LIPA
INSTITUTIONAL ADMISSIONS AND TESTING OFFICE
ADMISSIONS TEST PERMIT
Attach 2x2 picture,
Applicant’s Name: ______________________________________________________________________ Classification: _____ Guidelines: ____ white background
Last First M.I. with nameplate /
nametag
Admission Test Schedule: ________________________________________ Preferred Course / Strand / Level: _______________