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INTRAMUROS, MANILA MAKATI CITY

APPLICATION FOR SENIOR HIGH SCHOOL ADMISSION

Please accomplish and submit this form together with the other required documents at the Admissions Office.
Submitted documents in compliance with the entrance exam requirements shall become the property of the Admissions Office, and are not to be returned to the applicant.

AY 20___ - 20___

Name:
Family Name Given Name/s Middle Name

Academic Track: STEM (Science, Technology, Engineering and Mathematics) HUMSS (Humanities and Social Sciences)

ABM (Accountancy, Business and Management) General Academic

Date of Birth (mm/dd/yyyy) : Gender: Nationality:

Landline #: Mobile #:

E-mail Address:

Father's Name:
Family Name Given Name/s Middle Name

Landline #: Mobile #:

E-mail Address:

Mother's Name:
Family Name Given Name/s Middle Name

Landline #: Mobile #:

E-mail Address:

Guardian's Name:
Family Name Given Name/s Middle Name

Landline #: Mobile #:

E-mail Address:

High School Name:

Academic Strand:

Classification: ( ) Public ( ) Private - Sectarian ( ) Private - Non-Sectarian

To the Dean of Admissions and Scholarships:

I wish to apply for admission in your university as a new senior high school student (refers to an applicant without prior enrollment in other schools / universities) for Academic
Year 20__ - 20__.

I hereby attest to the completeness and accuracy of all the information supplied in this form. I understand that withholding of information or giving false information will make
me ineligible for admission, or may jeopardize my continued stay after admission has been granted. I also allow the university to release and use the information for legitimate
purposes specifically for evaluation for admission to the university. I allow the university to release information only to authorized personnel for the above stated purpose in
accordance with the Data Privacy Policy of the University

Respectfully yours,

Applicant's Signature above Printed Name/Date

This form may be reproduced. FM-AD-16-02