SeniorHigh Application Form

PERSONAL INFORMATION
ADDRESS
City
Barangay

FAMILY INFORMATION


Sibling 1:



Sibling 2:



Sibling 3:



ACADEMIC BACKGROUND
*ESC ID no. and QVR Code can be found on your ESC certificate or QVA certificate.
Extra-Curricular Activities
OTHER INFORMATION


Required *
HEALTH INFORMATION


Allergy / Surgery:
Visual Acuity:
Normal Vision
Wears Eyeglass
Auditory Perception:
Normal Hearing
Wears Hearing Aid
Physical Condition:
Normal Condition
Psychological Condition:
Normal Condition

HEALTH DECLARATION FORM

I certify that the above history is true to the best of my knowledge. I have fully disclosed all medical conditions that may affect my performance as a student of the school. I also understand that the School Health Services and the Guidance Office will not be liable to any untoward incident that may arise due to the deferral of the psychological service recommendation, physical examination and Chest X-ray.


I AGREE AND UNDERSTAND
SOCIAL ENVIRONMENT AND BEHAVIOR
Preferred Course/s in SDCA: