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    IS Application Form AY2024-2025

    Uploaded by

    hezeldt

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    IS Application Form AY2024-2025

    Uploaded by

    hezeldt
    9 views2 pages

    Original Title

    IS Application form AY2024-2025

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    9 views2 pages

    IS Application Form AY2024-2025

    Uploaded by

    hezeldt

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    APPLICATION FORM

    ACADEMIC YEAR:________________________

    L AST NAME FIRST NAME

    Staple (3)
    MIDDLE NAME NICKNAME 2X2 SIZE
    pictures here

    GRADE LEVEL APPLIED FOR:

    PERSONAL INFORMATION:
    DATE OF BIRTH AGE PL ACE OF BIRTH GENDER NATIONALIT Y CITIZENSHIP RELIGION

    month day year

    COMPLETE HOME ADDRESS

    No. Street Name Village / Subdivision Barangay Town City Zip Code

    FOR NON-FILIPINO CITIZENS:


    I-CARD NO.: DATE ISSUED: PL ACE ISSUED:

    REMARKS

    FAMILY INFORMATION
    FATHER MOTHER

    Name
    (Last Name, First Name, Middle Name)

    Nationality & Religion

    Home Address

    Home Number
    Mobile Number
    Email Address
    Highest Educational Attainment
    Last School Attended
    Company Name
    Position
    Office Address
    Office Number

    NAME OF SIBLINGS
    NAME GR./YR. LEVEL / OCCUPATION SCHOOL / EMPLOYER

    Is the child’s father or mother an alumnus/alumna of any De La Salle school? YES NO


    If yes, which La Salle school?
    Year Graduated
    CHILD ACADEMIC AND HEALTH INFORMATION

    EDUCATIONAL HISTORY
    ACADEMIC YEAR
    PRE-SCHOOL NAME AND ADDRESS OF SCHOOL
    AT TENDED
    Nursery

    Kinder

    GRADE SCHOOL

    Grade 1

    2
    3

    4
    5
    6
    JUNIOR HIGH SCHOOL
    Grade 7
    8
    9

    1. Has the child been placed under academic probation or given any sanction for poor academics? (If yes, please provide details)

    2. Has the child been placed under disciplinary probation or given any sanction for misbehavior? (If yes, please provide details)

    3. Has the child been diagnosed with any of the following? (Please check and specify)
    Vision Impairment Please specify
    Speech / Language Delay Please specify
    Learning Disability Please specify
    Behavioral Disorder Please specify

    4. Are there other concerns with the child’s health? (Please provide details)

    FINANCIAL DETAILS
    1. Who will be responsible for the payment of tuition and fees?

    Parents Other family members (grandparents, uncle, aunt, brothers, sisters, etc.)
    Educational plan, please specify Parent’s company benefit
    Scholarship

    2. Please check your gross annual family income P1M and above P999,000-P700,000
    P699,000-P400,000 P399,000-P100,000
    P99,000 and below
    IN CASE OF AN EMERGENCY, IF UNABLE TO CONTACT PARENT, CONTACT:

    Relative/Guardian Home Address

    Relationship to Applicant Home Phone Number

    Mobile Number E-mail Address

    OTHER INFORMATION
    How did you find out about the school?

    Referral Streamers Print Ads Website Others


    By whom?

    I certify that the information provided herein are true and correct, and do hereby give consent
    to DLSU-IS to collect and process all our personal data for purposes of admission/enrollment
    to said school/institution.

    Signature over printed name

    Relationship to applicant Date filed

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