FOR ADVISORY CLASS

NAME(Last Name, First Name, Name Extension, Middle Name) AGE: BIRTHDATE:

Pe Benito, Christine Joy, Openda 17 January 13, 2005

COMPLETE ADDRESS:
SEX: RELIGIOUS AFFILIATION:
(House No./ Street/ Sitio/ Purok, Barangay, Municipality/ City, Province)

#22 San Pablo st. Gulod, Novaliches, Quezon City Female ROMAN CATHOLIC

FATHER'S NAME(Last Name, First Name, Name Extension, Middle Name):

Pe Benito, Mario, Barros

MOTHER'S MAIDEN NAME (Last Name, First Name, Name Extension, Middle Name):

Openda, Ma. Lourdes, Valladolid Contact Number of

Parent/
GUARDIAN'S NAME: RELATIONSHIP: Guardian

Ma. Lourdes O. Pe Benito Mother 9309724212

LRN: WITH VOUCHER OR NOT

LRN: 112960100169 WITH VOUCHER

NAME OF SCHOOL (JHS): DATE OF GRADUATION/COMPLETION:

Sta. Lucia High School 2020-2021

SCHOOL ADDRESS (JHS): GEN. AVE (JHS):

JP Rizal St. Sta Lucia, Novaliches, Quezon City 95

CONTACT NUMBER

9165111960

PUBLIC OR PRIVATE

Public