PARENTAL CONSENT, TUITION FEE CONSULTATION

AND PARENTS’ ORIENTATION FORM

Date of Consultation and Orientation: __________________________________

Name of Student: Grade Level: _______

First Name Middle Name Last Name

Cellphone Number:

Name of Father:

First Name Middle Name Last Name

Cellphone Number:

Name of Mother:

First Name Middle Name Last Name

Cellphone Number:

Name of Guardian: (Skip if student is living with parent/s)

First Name Middle Name Last Name

Cellphone Number:

I grant my consent for my child to enroll at Living Stream Academy of St. Raphael, Inc. and I
hereby certify that I have attended the Parent’s Orientation on the date indicated above. I certify
further that the Tuition Fee and Online Distance Learning Modality have been fully explained to
me and as such, agree to the school’s terms and conditions with regard to these matters.

Signature of Parent/Guardian over printed name