AF-I.

05

 Lancaster New City, Cavite Philippines

 IMUS CAMPUS (046) 423.58.21 / 0915.359.99.37
 FAITH CAMPUS 0917.621.3751
 Email address: admissions@ses.edu.ph

APPLICATION FOR ADMISSION

Student Information Sheet
School Year: _______________
2023-2024
(Please accomplish this form accurately and completely.)
CHECK THE YEAR LEVEL APPLIED FOR: Enrolment Status:

Pre-Kinder Grade 1 Grade 3 Grade 5 Grade 7 ✔ Grade 9 Grade 11 Old ✔ Transferee

Kinder Grade 2 Grade 4 Grade 6 Grade 8 Grade 10 Grade 12 New Returnee

CHECK THE STRAND APPLIED FOR (For Senior High School Applicants Only)
STEM (Science, Technology, Engineering and Mathematics) HUMSS (Humanities and Social Sciences)
ABM (Accountancy, Business, and Management)
Learner Reference Number Student Number Section
4 2 4 0 4 3 1 5 0 0 6 4
P ersonal Information

Last Name First Name Middle Name

SOLIS ARIANNA LEI ALBOLERAS
Permanent Address
BLK. 8 LOT 25 PHASE 2 LAVANYA, BACAO, GENERAL TRIAS, CAVITE
Date of Birth (mm-dd-yyyy) Place of Birth Nationality Religion
0 2 - 1 7 - 2 0 0 9 TAGAYTAY CITY FILIPINO CATHOLIC

Enrolment History
Elementary School Name UNIDA NEHEMIAH CHRISTIAN ACADEMY School Year (from – to) 2015-2021

Junior High School Name UNIDA NEHEMIAH CHRISTIAN ACADEMY School Year (from – to) 2021-2023

Senior High School Name School Year (from – to)

Legal Guardian/R epresentativ e Information

Mother's Maiden Name LIZETTE YOLANGCO ALBOLERAS Father's Name WILSON MIRANDA SOLIS

Occupation FINANCE MANAGER Occupation BUSINESS OWNER

Employer DSCP INC. Employer AQUALEI WATER REFILLING STATION

Active Contact Number and Email Address Active Contact Number and Email Address
09190051303 zetsky2001@yahoo.com 09209119158 zetsky2001@yahoo.com

Guardian's Name (include relationship to the student) Active Contact Number and Email Address
LIZETTE A. SOLIS MOTHER 09190051303 zetsky2001@yahoo.com

Other information about the Applicant

Has your child had any behavioral or disciplinary problems at their previous school(s)? [ ✔ ] No [ ] Yes, please specify details
__________________________________
__________________________________
Does your child have any special health concern? [ ] No [ ✔ ] Yes, please specify details
__________________________________
RHEUMATIC HEART DISEASE
__________________________________
Does your child have any regular medication? [ ] No [ ✔ ] Yes, please specify details
__________________________________
EVERY 21 DAYS AFTER LAST INJECTION
__________________________________
Have you requested for a developmental/psychological/ learning assessment for your child? [ ✔ ] No [ ] Yes, please specify details
__________________________________
__________________________________
Did your child receive any forms of therapy (behavioral, speech, occupational), counseling, or [ ✔ ] No [ ] Yes, please specify details
academic tutorial from a professional? __________________________________
__________________________________

Disclaimer: Data P riv acy Notification and Consent:

I do hereby allow/authorize St. Edward Integrated School to use, collect and process all the information contained herein for
educational and other legitimate purposes and shall be processed by authorized personnel in accordance with the data privacy policies of the
school.
LIZETTE A. SOLIS
_______________________________________
5/29/2023
_________________________________
Signature over Printed Name Date Accomplished

Declaration
I hereby certify that the information given in this form is true and correct. I have read and understood all the rules & regulations given
the admissions process, and hereby agree and give consent to abide by them, if my child is selected for admissions. I also understood that the
registration of my child does not guarantee their admission to the school and that the Application fee is neither refundable nor transferable.
LIZETTE A. SOLIS
__________________________________________
5/29/2023
____________________________
Signature over Printed Name Date Accomplished

revised2023