CNSTHS Application No.

______

CALOOCAN NATIONAL SCIENCE AND TECHNOLOGY HIGH SCHOOL

Blk. 29 Congress Road, Bagumbong, Caloocan City Recent
Email Address: calnatsci@gmail.com 1” x 1”
Telefax No.: 351 - 8241 Photo

APPLICATION FORM FOR JUNIOR HIGH SCHOOL

INSTRUCTIONS to the Student-Applicants and Parents:

1. Read the direction carefully before filling out this form.
2. Print clearly and correctly all information asked for in this form.
3. Do not abbreviate. Write N/A if not applicable.
4. In printing student’s name, write one letter in each box and leave one box blank between names.
5. Documents filed in support of the application become property of CNSTHS and will not be returned
to the applicants.

PERSONAL INFORMATION

SURNAME

FIRST NAME

MIDDLE NAME

Nickname Birth Date Birth Place Gender Age Religion Contact Number/s

Complete Address:

FAMILY BACKGROUND

Father’s Name: ______________________________________ Age: ____ Contact No. _________________

Educational Background: Elementary Graduate: ___ High School Graduate: ___ College:___ Degree:_____________
If employed, name of company and employer:_________________________________ Position: ________________

Mother’s Name: ______________________________________ Age: ____ Contact No. ________________

Educational Background: Elementary Graduate: ___ High School Graduate: ___ College:___ Degree:_____________
If employed, name of company and employer:_________________________________ Position: ________________

Guardian/Contact Person in case of emergency: _______________________________ Relation: ________________

Telephone/Cellphone No. _______________ Home/Office Address: _______________________________________

SCHOLASTIC BACKGROUND

Present School: ___________________________________ School Address: ________________________________

School ID: ________________________________________ Learner’s Reference Number (LRN):_________________
Honors/Awards Received: _________________________________________________________________________
List your Elementary extra-curricular activities, positions, clubs: ___________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
List your hobbies/special skills/talents:
_______________________________________________________________________________________________
CNSTHS Form 2

CERTIFICATION OF CANDIDACY FOR GRADUATION

This is to certify that _______________________________________________________________ is a candidate

for graduation this school year 20 ___ to 20 ___. He/ she belongs to the _____________________ percentile rank
of the entire graduating class. This certifies further that he/ she has no grade lower than 85% in all subjects in
any grading period.

_______________________________________________________
Principal’s/School Head’s signature over printed name

CNSTHS Form 3

CERTIFICATE OF GOOD MORAL CHARACTER

This is to certify that ____________________________________________________________ has consistently

maintained good moral character and no disciplinary action whatsoever has been taken against him/her.

________________________________________________________________
Principal’s /Guidance Counselor’s signature over printed name

CNSTHS Form 4

APPLICATION LETTER

The Selection Test Committee

Caloocan National Science and Technology High School – Junior High School
Caloocan City

I, ____________________________________________________, presently a Grade VI pupil at

_____________________________________________________ have the honor to apply for admission to Caloocan
National Science and Technology High School – Junior High School through the selection tests. If I qualify, I
promise to report for an interview and enroll promptly within the period specified so that I will not lose my
enrollment privilege.

_________________________________________
Signature of Applicant over printed name

CNSTHS Form 5

PARENT’S PERMIT

I hereby give my consent to my son/daughter _____________________________________, a

Grade VI pupil at ________________________________________________ to take the Selection test for admission
to Caloocan National Science and Technology High School on ________________. If my child qualifies in the
examination and interview, he/she will promptly enroll in CNSTHS and will abide the rules and regulations of
the school.

___________________________________ ____________________________________
Signature of Father over printed name Signature of Mother over printed name