Student Information

CAMPUS: STI COLLEGE DASMARINAS

SCHOOL YEAR: 2022-2023 TERM: 1ST TERM

This portion is to be filled out by the school personnel. APPLICATION NUMBER ID NUMBER

SENIOR HIGH SCHOOL COLLEGE NEW STUDENT TRANSFEREE DAS2205280128

1 For Inquiries, provide the necessary information for this section only. Write in CAPITAL LETTERS. Put N/A if not applicable

CHOSEN PROGRAM / TRACK & STRAND / SPECIALIZATION YEAR / GRADE LRN / ESC No.

BMMA 2ND YEAR

Students's Name
FIRST NAME DATE OF BIRTH (MM-DD-YYYY)

JOHN RENZO 07 - 01 - 2000

MIDDLE NAME BIRTHPLACE CITIZENSHIP

MANILA FILIPINO

LAST NAME SUFFIX CIVIL STATUS GENDER

SEPLON SINGLE MARRIED* M F

Current Address
HOUSE / LOT / UNIT NO. STREET BUILDING / SUBDIVISION / VILLAGE / BARANGAY

BLK. 3 LOT 21 POPLARS LANCASTER RESIDENCESALAPAN II-A

CITY / MUNICIPALITY PROVINCE ZIP CODE

IMUS CITY CAVITE 4103

Permanent Address (Leave blank if the same as Current Address)

HOUSE / LOT / UNIT NO. STREET BUILDING / SUBDIVISION / VILLAGE / BARANGAY

BLK. 3 LOT 21 POPLARS ALAPAN II-A

CITY / MUNICIPALITY PROVINCE ZIP CODE

IMUS CITY CAVITE 4103

Contact Details
LANDLINE (e.g. 046 123-4567) MOBILE (e.g. 0917 123-4567) EMAIL

09954830756 RENZO07012000@GMAIL.COM

Last School Attended DATE OF GRADUATION (MM-DD-YYYY)

HIGH SCHOOL** JUNIOR HIGH SCHOOL SENIOR HIGH SCHOOL ALS A&E / PEPT*** COLLEGE - -

NAME OF SCHOOL PROGRAM / TRACK & STRAND / SPECIALIZATION S.Y.(e.g. 2017-2018) YEAR / GRADE TERM

MAPUA UNIVERSITY INTRAMUROS B.S. ARCHITECTURE 2019 - 2020 1ST YEAR COLLEGE

2 For Enrollment, completely fill out the entire form including this section. WRITE in CAPITAL LETTERS. PUT N/A if not applicable.

Only Parents and the Designated Guardian are allowed to conduct any transaction with the school and its personnel. Please provide a valid email address for the dissemination of grades and official
school communications.

Father's Name
FIRST NAME M.I. MOBILE (e.g. 0917 123-4567) OCCUPATION

ROGELIO E 09561656460 SALESMAN

LAST NAME SUFFIX EMAIL

LAFORTEZA JR.

Mother's Name
FIRST NAME M.I. MOBILE (e.g. 0917 123-4567) OCCUPATION

JADYSSIS S 09954780327 OFW

LAST NAME SUFFIX EMAIL

ZAMORA JADESEPLON@YAHOO.COM

Designated Guardian
FIRST NAME M.I. MOBILE (e.g. 0917 123-4567) OCCUPATION

JERIZZA A 09954780327 SELF EMPLOYED

LAST NAME SUFFIX EMAIL RELATIONSHIP

SEPLON JIMJERIAUG2000@GMAIL.COM AUNTIE

*Married students should provide Certificate of Marriage; **Students who graduated from secondary school under the old curriculum; ***Alternative Learning System Accreditation
& Equivalency / Philippine Educational Placement Test
Terms & Conditions
Definitions Refund Policy
Registration Assessment Form (RAF) Students who wish to drop a course or withdraw from a program may
It refers to this form. This shall serve as the contract between the do so in writing and will be subjected to the penalty charges, as stated
student and STI to promote and protect mutual interests and for the below.
parties to fulfill their responsibilities and financial obligations. It contains
the assessed tuition and other fees of a student in a given term/year. Tertiary Students

Registration Fee Date of filing for Dropping/Withdrawal Penalty charge

The sum due to STI to register a student to a class. Before the start of classes Registration fee for the term

School Fees Within 7 calendar days from the start of 10% of the total amount due to
All costs incurred in the usual course of the education by STI, including classes term
the provision for necessary educational materials as outlined in the
Schedule of Fees. Any additional costs incurred by STI in providing Beyond 7 calendar days but not beyond 20% of the total amount due to
the educational needs of the student will be charged as addition to the 14 days from the start of classes term
School Fees.
Tuition & Other School Fees (Tertiary) Beyond 14 calendar days from the start 100% of the total amount due
of classes to term
Registration & School Fees (Senior High School)

Down Payment Senior High School Students

The full initial payment required upon enrollment in order for a student) Date of filing for Dropping/Withdrawal Penalty charge
to be considered as officially enrolled.
Before the start of classes Registration fee
Amount Due
The total due required for payment. Within 7 calendar days from the start of Registration fee +10% of the
classes annual school fees
Designated Guardian
Person who has the legal authority and duty to care for the interests of another. Beyond 7 calendar days but not beyond Registration fee +20% of the
another. 14 days from the start of classes annual school fees

Dropping/Withdrawal Beyond 14 calendar days from the start Registration fee +100% of the
of classes annual school fees
Cancellation of one or all enrolled subjects in a given term.

Payment Schedule
Data Privacy Consent
The due dates for settlement of accounts.
STI recognizes the fundamental right of all individuals to the privacy of
Enrollment his/her personal information in accordance with the Republic Act (RA)
No. 10173 or the Data Privacy Act of 2012. By signing this form, you
STI reserves the right to cancel the student’s enrollment due to: consent to the collection, generation, use, processing, storage and
Failure to pay the required down payment retention of your personal data for the purposes described in the STI
Data Privacy Policy under https://www.sti.edu/dataprivacy. You also
Submission of false documents and/or incorrect information authorize STI to disclose your information to third parties, whether local
Failure to submit requirements before Midterm Exams / 1st or foreign, as required or authorized by or under the law.
Quarter Exams

It is the responsibility of the student applicant to ensure that all Undertaking

supporting documents are received by the Office of the Registrar or the
appropriate Department.
A student is considered enrolled after he/she has submitted the
appropriate admission requirements and paid the down payment in full
or the total amount due as stated in this form.
"I hereby affirm that I have read and fully understood the foregoing
policies. I further undertake to obey all the rules and regulations of STI;
and acknowledge that any infraction or misrepresentation on my part
gives the school the right to institute an action against me before the
appropriate court and or administrative tribunal."

Payment
a. The registration fee is non-refundable.
b. All payments including the registration fee is done through the school Student Signature
cashier or other authorized payment channels.
c. Any activities outside the core curriculum (including, but not limited
to sports, field trips, and seminars) in which the student may Parent's/Designated Guardian's Signature Over Printed Name
participate shall be deemed supplemental and will be charged
accordingly.