MUNTINLUPA SCIENCE HIGH SCHOOL THIS FORM IS NOT FOR SALE

SELECTION ADMISSION TEST AND MAY BE PHOTOCOPIED.

APPLICATION FORM for S.Y. 2020-2021

INSTRUCTIONS: Staple only

Type or print legibly all information needed. DO NOT ABBREVIATE. DO NOT LEAVE ANY ITEM BLANK. 1x1
Countersign all erasures and corrections made. Submit two (2) original copies.
Photo
DEADLINE OF SUBMISSION: January 17, 2020

I. PERSONAL DATA:
1. NAME OF APPLICANT (Last Name, First Name, Middle Name) 2. LEARNER'S REF. NO.(LRN):

3. BIRTHDATE: 4. SEX: 5. CONTACT NUMBERS: 6. EMAIL ADDRESS

(Pls. include all possible contact numbers)
Male
MM DD YYYY Female

7. AGE by June 1, 2020:

8. COMPLETE HOME / PERMANENT ADDRESS

H. PARENTAL CONSENT:
I hereby give my consent to who is in good health, to take the Selection
Admission Test in your school on February 1, 2020. If my child qualifies through the examination and interview, he/she will
promptly enroll in your school and will abide by all the policies and procedures of the school.

Signature of Parent/Guardian over printed name

III. TO BE FILLED OUT BY THE PRINCIPAL OR SCHOOL HEAD:

5. Pupil's RANK in the Batch:
1. NAME OF SCHOOL (Write name of school in full):
6. No. of Pupils in the Batch:

7.1st Grading Grade in: 250 Grading Grade in:

Science Science
2. COMPLETE SCHOOL ADDRESS:
Math Math

English English

3. SCHOOL TYPE: Public Private 8. GRADING SYSTEM USED:

4. CONTACT NOS.:

1. 1 herebycertify that the pupil-applicant is currently I certify that the pupil-applicant is of good moral character
enrolled in his/her 6th year of basic elementary education. and has never been cited for violation of school rules and
regulations or case of misbehavior or violation of any
2.I also certify to the accuracy of the data above. ordinance or laws of the country.

Principal/School Head's Signature over Printed Name Guidance Counselor/Adviser's Signature over Printed Name
( ) Affixed is the School's Dry Seal.
( ) The School has no Dry Seal.

Who is qualified to take the Admission Test?
(as stated in City Ordinance No. 16-156)
1. Applicant must not have a grade below 83% in,
Science, Math & I .tiglish and no grade. below
80% in all other subjects in the 2 immediately
preceding grading periods in the Grade 6 level
of the current school year.
2. 'I'he parent of the applicant must be a:
• Resident of the City of Muntinlupa.
• Registered voter of the City of Muntinlupa.
Submit the following to the Guidance Office: For use of the MSHS Collecting Officer:
• Fully accomplished Application Forms (2 copies);
• Four (4) identical 1 x 1 ID pictures of the Amount Paid:
applicant with white background and must have
been taken within the last six months;
Payment Received by:
• Original and photocopy of report card;
• Original and photocopy of Voter's ID of parent;
• Barangay Certification of Residency of parent;
• Non-refundable testing fee of Php200 for private
school students (FREE for public school
Date:
students).