Xavier University TUNIOR HIGH SCHOOL GRADES FORM ~ XU-ADC JUNIOR HIGH SCHOOL ADMISSIONS XU-ADC JUNIOR HIGH SCHOOL APPLICATION SUPPORTING DOCUMENT To the Applicant: Please forward this form to your Class Adviser/Registrar or Principal. First step of the ‘admissions process is the evaluation of your grades. Submission of false records may be a ground of non- admission. To the Class Adviser/Register/Principal: The pupil/student whose name appears on this form Is applying for Xavier University - Ateneo de Cagayan JHS as Grade Please do assist us on the following data. Thank you! Learner Reference Number (LRN): \2"VULU C0 1) Date: Name of Applicant Applying for Scholarship? _Yes __No (check that applies) GRADE FORM GUIDELINES Only the class adviser/ registrar/ principal may certify this Grade Form. State the grades in standard quantitative equivalent (e.g 80.00 or 85.00). Record the grades for English, Filipino, Mathematics, Science and General Average. General Average Grade includes all subjects taken. Indicate ranking of applicant in the previous school year with total number of students in the batch (e.g 1st/500 6. Affix school seal on this document for validation. 7._Counter sign all corrections made. A. Please provide the Final Grade requested. Grade Level English Filipino | Mathematics | Science | General Rank (neous Soa | Average | | Grade V Ab] a0 a 31% aoe 44h indicate grade level B. Fill in up to the latest quarter marks released. [" Gradetevel [~ English | Filipino | Mathematics | Science | General Rank (present school | Average year; indicate what | | grade level) | First Quarter x1 on gg ye a Second Quarter_ | G> “Ww > “lo ay a xu. | 49 | Third Quarter Ao gael gy 4 a Fourth Quarter ay V™l x1 | aL ay AG) ] Address of School:_@a\o\~ cra C\nHbyi33, Mis: Ov Place school seal Aa ow here ak TL Certified by:_ma@s pain S&- merconag Prine (Name and Signature)