Admission Details

---- UCDPDJC Freshmen Senior Highschool Graduate 2021-07-07

Student ID Admission Reference Admission Status High School Curriculum Date of Application

Personal Information
Robert Ubas Mellibo -
First Name Middle Name Last Name Name Ext.
1013, 101313, 101314002, Zone 2, Manolo Fortich No
Address (Street/Lot/Block, Barangay, Municipality/City, Province) Disablity
Manolo
2002-06- Born
Fortich, Male Single 09380331240 Ladilysamuya971@gmail.com
05 Again
Bukidnon
Birthday Place of Birth Sex Civil Status Religion Mobile No. Email Add.

Family Background
Lenie -. Ubas House Wife -
Mother's Name Mother's Occupation Mother's Contact No
Robert Sr. Arcete. Mellibo Driver 09261341541
Father's Name Father's Occupation Father's Contact No
3,000 - Below 3 0 - -
Parent's Income No. of Siblings No. of Children Name of Spouse Name of Guardian

Contact Person In-case of Emergency

Lenie Mellibo 09261341541 Zone 2, Alae, Manolo Fort
Name Contact No. Relationship

If Working Student
-
Type of Working Environment

Educational Background
Level Name of School Address Year (Graduated/Last Attended)
Alae Central Elementary Alae, Manolo Fortich,
Elementary 2015
School Bukidnon
Balubal National High Balubal, Cagayan De Oro
(Junior) High School 2019
School City
Balubal National High Balubal, Cagayan De Oro
(SHS) High School 2021
School City
(SHS) Track and Strand Gas
(Transferee) Last School - - -
I hereby declare that all the above mentioned information is true and correct.

Signature over Printed Name Date Signed