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RIZAL NATIONAL SCIENCE HIGH SCHOOL

JP Rizal St. Batingan, Binangonan, Rizal, Philippines 1940
Registrar’s Office: (02) 719-2353 Principal’s Office: (02) 652-2197
rnshsbinangonan1@gmail.com www.facebook.com/risciregistrar

ADMISSION FORM FOR JUNIOR/SENIOR HIGH SCHOOL

S.Y. 2020 – 2021
Note: This form is not for sale, it may be photocopied Application No. ___________

IMPORTANT:
 Fill out all the necessary information below. Type or print legibly. 1” × 1”
colored
 DO NOT ABBREVIATE. Countersign all erasures and corrections made. picture w/
 DEADLINE OF SUBMISSION: December 20, 2019 Date of Entrance Test: January 11, 2020 name tag
Surname, First Name, M.I.

DATA PRIVACY NOTICE CONSENT:

The Rizal National Science High School engages in the collection of personal information as stated in this RSET application form intended for incoming
Grade 7 & 11 students. All personal information collected by our school shall be utilized for the needed data and it will be treated with utmost confidentiality.
All information collected shall be processed, utilized, retained, and disposed by authorized personnel in accordance with the relevant policies of the Department
on usage, retention and disposal of its records. I am hereby authorizing RNSHS - Office of the Registrar to collect, retain & dispose of my personal information
in accordance with DepEd policies. Signature:

PERSONAL DATA Please check the appropriate box:

Junior High School
1) NAME OF APPLICANT: (On Birth Certificate) Strand:________ Senior High School

Last Name First Name Middle Name Ext. Name (if any)

Month Day Year

2) SEX: Male Female 3) BIRTH DATE: / / 4) RELIGION:

5) PLACE OF BIRTH: 6) CITIZENSHIP:

Write your complete address

7) ADDRESS: 8) CONTACT NO.:

I hereby certify that the information above are true and correct. I understand that any false or misleading information will
result to the disapproval of this application for admission.
____________________________________
Attested by: _____________________________________________ Signature of Applicant over Printed Name
Signature of Parent or Guardian over Printed Name

SCHOOL’S CERTIFICATION
1) NAME OF SCHOOL: 2) COMPLETE SCHOOL ADDRESS:

3) SCHOOL TYPE: PUBLIC PRIVATE 4) SCHOOL CONTACT NO.:

5) GEN. AVERAGE: Rank in the Graduating Class ___ No. of Graduating Students ____
We hereby certify:
1) That the pupil/student-applicant is officially enrolled as Grade 6 (for JHS) and Grade 10 (for SHS) in the school year 2019-2020.
2) That he/she belongs to the upper 10% (public schools) and upper 5% (private schools) of the graduating class and with a grade not
lower than 85% in the 2nd grading period in all learning areas particularly in Science and Math subjects.
3) That the pupil/student-applicant is of good moral character.
4) That the pupil/student-applicant is highly recommended to take the exam.
5) That the forgoing data / information are accurate.
______________________ ______________________ ______________________ ______________________
*Class Adviser *Guidance Counselor *School Registrar *School Principal
(*Signature over Printed Name)

 Certified photocopy of SF 10 (F-137) and SF 9 (F-138) for the 1st & 2nd Quarter (SY 2019-2020)
REQUIREMENTS

 Two (2) pcs identical colored pictures w/ nametag

 Original and photocopy of PSA/NSO/LCR Birth Certificate
 Barangay Certificate of Residence
 Photocopy of NCAE Results for SHS incoming Grade 11. (NOTE: The NCAE results should have high scores in Science & Math subjects)
 Certification from the principal that he/she ranked 1st or 2nd among the graduating class (public school only)

For RNSHS Registrar’s use only Date: _____________

As per data below and submitted requirements:
Processed by: ____________________ Payment Received by: ___________________ Approved Disapproved