KEITECH EDUCATIONAL FOUNDATION, INC.

KEITECH LEYTE CAMPUS

Barangays Rizal and Hiluctogan, Kananga, Leyte
corporate@keitech.org.ph

OFFICE OF THE REGISTRAR

APPLICATION FOR ADMISSION

Student No:

ULI#: Date of Application :

PERSONAL INFORMATION

LAST NAME : FIRST NAME MIDDLE NAME

M.I. : EXT. NAME

BIRTH PLACE
Region : Province : City/Town :

DATE OF
: SEX : STATUS :
BIRTH
CONTACT INFORMATION
Email
: Mobile No. : Tel. Number :
Address
Complete Permanent Mailing Address
Number,
: Barangay : District :
Street, Sitio

Region : Province : City/Town :

EDUCATIONAL BACK GROUND

Elementary : Year Graduated :

High School/
Junior High
: Year Graduated :

Senior High : Year Graduated :

College : Year Graduated :

CONTACT PERSON IN CASE OF EMERGENCY

FULL NAME : Relationship : Mobile No. :

ADDRESS :

SECTOR APPLIED FOR:

METALS AND ENGINEERING SECTOR

● Electrical Installation Maintenance NC II
● Sheilded Metal Arc Welding NC II
● Gas Tungsten Arc Welding NC II
● Scaffolding Works NC II (Supported Type Scaffold)

CONSTRUCTION HANDCRAFTSMAN
● Scaffolding Works NC II (Supported Type Scaffold)
● Sheilded Metal Arc Welding NC I
● Sheilded Metal Arc Welding NC II

Are you a TESDA National Certificate holder?

YES NO

If yes, please write down the qualification/s:

QUALIFICATION FOR ADMISSION

1. At least High School Graduate with GWA of 80% or Higher

2. A resident of Kananga and Ormoc or EDC endorsed coming from the host communities and other project sites
3. Physically fit and of good moral character
4. Age Requirement: Must be 18-35 years old
5. Special Requirements per Qualification Area:

Metals and Engineering and Construction Applicants:

-Should have a final grade in Mathematics at least 80% or higher

ADMISSION REQUIREMENTS:

Preliminary requirements upon taking the Entrance Examination:

1. Filled out Application Form
2. Letter of Intent or Application Letter
3. 2 Pieces Passport Size pictures (white background; collared shirt)
and with Name and Signature
Second batch of requirements to be submitted before Interview:
1. Photocopy of Report Card/TOR/Form 137
2. Certificate of Residency/Barangay Clearance indicating that applicant is non-dependent to
or non-user of illegal drugs and alcohol

Final requirements to be submitted upon enrolment:

1. Physical Examinations (Medical & Diagnostic)
2. Original copy of Report Card/Form 137/Transcript of Record
3. Good Moral Character Certificate from last school attended
4 PSA/NSO Birth Certificate
5. Certificate of Indigency
6. Police Clearance

CERTIFICATION

1. I attest that all entries I made herein are true and correct. Any false or incomplete entry may cause my disqualification for admission.

2. I hereby allow KEITECH to use/post my contact details, name, email, cellphone/landline numbers and other information I provided which maybe
used for processing of my scholarship application, for employment opportunities and other purposes.

Applicant's Signature over printed Name