HS Admission Application Form

APP #
Katipunan Avenue, Loyola Heights

Quezon City, Philippines 1108
P.O. Box 154, Manila, Philippines
PHONE (+632) 426 6001 ext. 6291-6292
URL www.ateneo.edu/hs
Important : Applicants may take the entrance test for first year (or second year) only once.
Application Requirements and Procedures:
1. Pay the non-refundable application and testing fee of Seven Hundred Pesos (Php700.00) at the High
School Cashier, made payable to the Ateneo de Manila University (for check payments). For applicants
from foreign schools, pay an additional US$25.00 for processing fee.
FIRST NAME
2. Present the Official Receipt to the Office of Admission and Aid. Complete this form carefully,
answering all questions. Then return this form to the Office of Admission and Aid together with the
following requirements at least two (2) weeks before the High School Entrance Test.
a. Photocopy of applicants Report Card for the last completed grade level. For applicants from
the Ateneo Grade School (AGS), submit also a photocopy of the Grade 5 Report Card.
b. Photocopy of applicants Report Card for the first grading period of the current school year.
c. Two (2) recent ID pictures (1" x 1").
d. Photocopy of applicants Birth Certificate (NSO Copy).
i. If applicant is not a Filipino citizen, submit a photocopy of his (1) Alien Certificate of
Registration (ACR) and (2) a Special Study Permit issued by the Bureau of Immigration.
ii. If applicant has dual citizenship, submit a photocopy of his Philippine Passport or
Certificate of Recognition as a Filipino Citizen.
e. Additional requirement for applicants for second year: Two (2) Letters of Recommendation from
the last school attended.
LAST NAME
APPLICATION FOR ADMISSION
3. Handwritten autobiography on size A4 bond.

4. Only applications with complete requirements will be processed.
5. Credentials filed in support of this application become the property of the Ateneo de Manila High School
and will not be returned to the applicant.
NAME ____________________________________________________________________________________
Last Name (On Birth Certificate)
First Name
Full Middle Name
HOME ADDRESS ___________________________________________________________________________
MIDDLE NAME
PERSONAL INFORMATION
ZIP CODE __________ TEL. NO. __________ MOBILE NO. _______________ EMAIL ____________________
DATE & PLACE OF BIRTH __________________ CITIZENSHIP _______________ RELIGION _____________
CITIZENSHIP _______________ RELIGION _______________ OCCUPATION __________________________

MOTHERS NAME ____________________________________________________ [ ] LIVING [ ] DECEASED
CITIZENSHIP _______________ RELIGION _______________ OCCUPATION __________________________
GUARDIANS NAME (If applicable) ______________________________________________________________
ADDRESS _________________________________________________________________________________
RELATION TO APPLICANT __________ TEL./MOBILE NO. __________ OCCUPATION __________________
Year Level Applying For
FATHERS NAME ____________________________________________________ [ ] LIVING [ ] DECEASED
SCHOLASTIC BACKGROUND
List all schools you attended beginning from the lowest grade.
ELEMENTARY SCHOOL
LOCATION
GRADE/S
______________________________ _________________________ Grade ___ to Grade ___ SY _____ to SY _____

HIGH SCHOOL
LOCATION
YEAR/S
______________________________ _________________________ Year ____ to Year ____ SY _____ to SY _____

Have you ever applied to the Ateneo de Manila High School prior to this application? _____ YES _____ NO
If YES, when? ____________________ For what year level? ____________________
List your extra-curricular activities,
including positions held.
List any honors or prizes you have

received for scholastic achievement.
List your community or church

activities.
Were you ever dismissed from any school or denied re-admission? _____ YES _____ NO. If YES, provide name of
school, school year and reason/s.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Did you ever repeat a grade/year? _____ YES _____ NO. If YES, provide name of school, school year and reason/s.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Were you ever placed on probation status? _____ YES _____ NO. If YES, provide name of school, school year and
reason/s.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Name of the Principal, Headmaster or Director of your present school _________________________________________
School Adress ___________________________________________________________ Tel. No. __________________
Attach
recent
1 x 1
ID photo
Health and Physical Fitness

Date of your last physical exam ____________________
Name of physician ______________________________
List any health problems/medical conditions which should be taken into consideration in planning your school activities.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Have you ever been forced to stop schooling for a month or more because of poor health? _____ YES _____ NO. If YES,
provide details and dates.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Autobiography
Please write a brief handwritten autobiography touching on the following points: your chief interests, ambitions,
accomplishments, and your desire for a high school education at the Ateneo de Manila University. This is an important
part of your application and a good opportunity to make yourself known to the Committee on Admission and Aid. Take
time to think about what you will write and give attention to the fundamentals of good writing (content, organization, and
mechanics such as grammar and spelling). Make sure not to simply repeat information already provided in other pages of
this form.
Financial Aid
Are you applying for Financial Aid from the Ateneo? _____ YES _____ NO. If YES, secure a copy of the Financial Aid
Questionnaire from the Admission and Aid Secretary. Fill up the questionnaire and provide a complete set of required
documents before submitting the same to the Office of Admission and Aid together with this application form. Financial
Aid Questionnaires with incomplete requirements will not be processed.
Recommendations
Give the names and addresses of the persons who will send your Letters of Recommendation if requested by the
Committee on Admission and Aid. Choose two (2) persons who know you well and who have held positions of authority
over you in your present school (ex. teacher, counselor or principal). Do not include relatives or friends.
Name
Position
Address
CERTIFICATION
I hereby certify that all information supplied in this application is accurate and complete, and I authorize Ateneo
de Manila High School to verify all information supplied herein. I further certify that I have not applied for the
same year level in Ateneo de Manila High School prior to this application. I fully understand that
misrepresentation of information supplied herein will be considered sufficient reason both for refusal of
admission and exclusion.
Fathers/Guardians Signature _________________________
Applicants Signature _________________________
Mothers/Guardians Signature _________________________
Date ____________________
LAST NAME
FIRST NAME
MIDDLE NAME
DO NOT WRITE BELOW THIS LINE

Date Application Received ____________________
Action of the Committee on Admission and Aid:
[ ] ACCEPTED
[ ] WAIT-LISTED
[ ] To take SEP in:

[ ] Elementary Algebra
[ ] Basic English Speech
[ ] REJECTED
[ ] Basic Grammar
[ ] Reading
[ ] For acceleration
[ ] Basic Filipino
Date of Decision ____________________ Date of Notification ____________________

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APP #

Katipunan Avenue, Loyola Heights

APPLICATION FOR ADMISSION

3. Handwritten autobiography on size A4 bond.

CITIZENSHIP _______ RELIGION _ OCCUPATION ____________________

Year Level Applying For

FATHERS NAME ____________________________________________________ [ ] LIVING [ ] DECEASED

________ _ Grade _ to Grade _ SY _ to SY ___

________ _ Year to Year SY _ to SY ___

List any honors or prizes you have

List your community or church

Health and Physical Fitness

Applicants Signature _________________________

Mothers/Guardians Signature _________________________

DO NOT WRITE BELOW THIS LINE

[ ] To take SEP in:

Date of Decision Date of Notification

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