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PLM Admi
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PLM Appl
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Pamant
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APPLI
CANTI
D:202243955

PERSONALI
NFORMATI
ON:
FULLNAME: Gl
enn Bat
aycan I
dul
sa
Fi
rstName Mi
ddl
eName LastName Ext
ensi
onName
ADDRESS: 1929Sev
eri
noRey
esSt
.St
a.Cr
uzMani
l
a-Bar
angay353SANTACRUZ,
CITYOFMANI
LA
PROVI
NCE: NCR,
CITYOFMANI
LA,
FIRSTDI
STRI
CT(
NotaPr
ovi
nce)
REGI
ON: NATI
ONALCAPI
TALREGI
ON(
NCR)
BI
RTHDATE: Sep12,
2003 BI
RTHPLACE: Mani
l
a GENDER:
M
CONTACTNO: 09089328198 EMAI
L-ADDRESS: gl
enn.
idul
sa1212@gmai
l
.com

FAMI
LYI
NFORMATI
ON:
Part
icul
ars Father Mother
Ful
lName Glener
ioTagur
maconIdulsa Glor
iaTij
amoBataycan
Address 1929Severi
noReyesSt.Sta.Cr
uzManil
a 1929Severi
noReyesSt.Sta.Cr
uzManil
a
ContactNo. 09096866008 0
Occupati
on Carpent
er None
FamilyMonthl
yIncome: BetweenPHP10,481andPHP20, 962 BetweenPHP10,481andPHP20, 962

SCHOOLI
NFORMATI
ON:
LRN: 136446090238
STRAND STEM
SchoolName Arel
lanoUni v
ersit
y
SchoolAddr
ess NCR, CITYOFMANI LA,FIRSTDI STRICT( NotaPr
ovi
nce)
SchoolEmai
lAddress hs.j
uansumul ong@arel
lano.edu.ph
GeneralWei
ghtedAver
age(
GWA) Grade11: 94.00
Progr
am Choice1: BachelorofScienceinCivilEngineer
ing
Progr
am Choice2: BachelorofScienceinPsy chology
Progr
am Choice3: BachelorofScienceinComput erEngineeri
ng

DATAPRI
VACYCONSENTFORM

ThePamant asanngLungsodngMay nil

a(PLM)andi tsdulyauthor
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3/
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GLENNB.I
DULSA MARCH27,
2022
Si
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ntedNameof Dat
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Appl
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GLENERI
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DULSA MARCH27,
2022
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