APPLICATION FORM

PHOTO OF STUDENT
Date of Application

Control #

Reference #

Application for Current School Year

Next School Year

Other ______________

STUDENT APPLICANT
Last Name

Nickname / Preferred Name

Citizenship

First

Middle

Date of Birth (day / month / year)

Nationality

Place of Birth (city, country)

Gender

Native Language/s

Religion / Faith

Home Address

Home Telephone

EDUCATIONAL HISTORY
Current / Most Recent School

Grade Levels Attended

Website

Last Grade Level Completed

Last month/year attended

School Address

School Calendar Year

Head of School and E-mail

Other Schools Attended

Name of School & Country

Type of School

(Preschool, Elementary)

Attended
From

month/year

To

month/year

Grade
Level

International
School
(yes/no)

Language of
Instruction

PCPD Building, 2332 Don Chino Roces Avenue Extension, Taguig City, Philippines
TELEFAX (632) 810-5046 (632) 840-5040
E-MAIL admissions@beaconschool.ph
WEBSITE http://www.beaconschool.ph

 Has your child ever repeated or skipped a grade / class/ year level?

YES

NO

YES

NO

YES

NO

YES

NO

YES

NO

YES

NO

If YES, please give details

Does your child, to your knowledge, have any particular learning disabilities?

If YES, please give details

Has your child received remedial assistance in previous schools?

If YES, please give details

Does your child have any special educational needs?

If YES, please give details and provide copies of any previous reports

Has your child had any behavioral / disciplinary difficulties at previous schools?

If YES, please give details

Does your child have any special concerns (e.g. speech, language, health, others)?

If YES, please give details

STUDENT INTERESTS
Please indicate if your child has any special interests in the following:

arts and design

ballet

badminton

swimming

boy/girl scout

creative writing

modern jazz

basketball

taekwondo

camping

drama

drums

chess

tennis

debate

drawing

guitar

golf

track and field

school magazine

sewing

piano / keyboard

rugby

volleyball

student council

photography

strings

scuba diving

water polo

yearbook

website design

vocal music

soccer

other sports _________

other _____________

Does your child represent the school / club / country in any sporting, musical, drama event? Yes

If, yes, please describe activity(ies)

No

FAMILY INFORMATION
Father / Guardian 1 Relationship to Applicant
Last Name

Preferred Name / Nickname

First

Middle

Nationality (as per passport)

Highest Educational Achievement / School

Home Address

Telephone

Mobile Phone

E-mail

Business Name / Business Address

Business Telephone

Position / Occupation

Mother / Guardian 2 Relationship to Applicant

Last Name

Preferred Name / Nickname

First

Middle

Nationality (as per passport)

Highest Educational Achievement / School

Home Address

Telephone

Mobile Phone

E-mail

Business Name / Business Address

Business Telephone

Position / Occupation

Who is the custodial parent / guardian?

Father / Guardian 1

Mother / Guardian 2

Both

To whom should admission correspondence be sent?

_________________

Father / Guardian 1

Mother / Guardian 2

Both

Name of Child/ren

Age

Date of Birth

Current School

Current Level

Emergency Contact Information (aside from Parents / Guardians)

Full Name

Relationship to Child

Address
Telephone

Mobile Phone

E-mail

Failure to provide complete and accurate information of any kind on this form will void the application and could result in the student being
permanently dropped from Beacon School after being enrolled. The Beacon School reserves the right to determine the placement of the applicant
in the grade level deemed most appropriate for the student.
All information submitted is deemed confidential and will be treated as such by Beacon School.
To the best of my knowledge, the information submitted on this form is true and correct.

Signature of Father / Guardian

Signature of Mother / Guardian

Date