Application Form for Incoming Grade 11 Students

Instructions:

Please accomplish this application form and submit to the Guidance office
together with the following documents: 2” x 2”
For Students:
1. Form 138 (Grade 9) PICTURE
2. Two copies of 2” x 2” picture with white background
3. Certificate of Good Moral Character.
4. Birth Certificate (Original and Photocopy)
5. NCAE Result (if available)

For Parents/Guardian:
1. Updated Voter’s Certificates
2. Community Tax Certificate
3. For guardians, submit notarized Affidavit of Guardianship
Learner’s Reference Number (LRN):__________________________
FULL NAME OF THE STUDENT

LAST NAME FIRST NAME MIDDLE NAME

BIRTHDATE AGE GENDER RELIGION

HOME ADDRESS

PHONE NO. MOBILE NO. E-MAIL ADDRESS

CURRRENT SCHOOL
Public Private

SCHOOL ADDRESS

FATHER'S NAME

HIGHEST EDUCATIONAL ATTAINMENT

PHONE NO. MOBILE NO. E-MAIL ADDRESS

OCCUPATION

COMPANY/BUSINESS NAME AND ADDRESS

VOTER REGISTRATION RECORD NO. BARANGAY PRECINT NO.

MOTHER'S NAME

HIGHEST EDUCATIONAL ATTAINMENT

PHONE NO. MOBILE NO. E-MAIL ADDRESS

OCCUPATION

COMPANY/BUSINESS NAME AND ADDRESS

VOTER REGISTRATION RECORD NO. BARANGAY PRECINT NO.

GUARDIAN'S NAME

HIGHEST EDUCATIONAL ATTAINMENT

PHONE NO. MOBILE NO. E-MAIL ADDRESS

OCCUPATION

COMPANY/BUSINESS NAME AND ADDRESS

VOTER REGISTRATION RECORD NO. BARANGAY PRECINT NO.