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for better user experience.
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Congratulations!
Please present your Applicant ID to the admission officer.
Applicant ID:
00001
Reservation Fee:
0.00
DONE
CANOSSA ACADEMY
Fill up the registration form and pay the
Reservation Fee (
0.00
)
at the cashier to reserve a slot.
PERSONAL & SCHOLASTIC INFORMATION
APPLICATION FOR ADMISSION
Grade Level Type:
*
Grade Level:
*
Student Type:
*
Junior High Grade Gen. Ave.:
*
Junior High Graduation Date.:
*
Track:
*
Strand:
*
Specialization:
*
PERSONAL INFORMATION
First Name:
*
Middle Name:
Last Name:
*
Extension Name:
Gender:
*
Select Gender
Male
Female
Marital Status:
*
Select Status
Single
Married
Separated
Divorced
Widowed
Date of Birth:
*
Place of Birth:
(City/Municipality)
*
(Province)
*
Contact Number:
*
Email Address:
*
Nationality:
*
Passport No.:
*
Visa Status:
*
ACR No.:
*
Authorized Stay:
*
Religion:
Current Address:
(House No. / Unit No. / Floor, Street / Subdivision / Barangay)
*
City:
*
SCHOLASTIC RECORDS
Learning Reference Number (LRN):
*
Education Service Contracting (ESC) ID:
*
Qualified Voucher Recipient (QVR) ID:
*
EDUCATIONAL BACKGROUND
PREP/KINDER/NURSERY
School ID
School Name
School Address
Grade From
Select Grade
Nursery
Kindergarten
Preparatory
Grade To
Select Grade
Nursery
Kindergarten
Preparatory
SY From
SY To
Add Prep/Kinder/Nursery
GRADE SCHOOL
School ID
School Name
School Address
Grade From
Select Grade
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade To
Select Grade
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
SY From
SY To
Add Grade School
JUNIOR HIGH SCHOOL & SENIOR HIGH SCHOOL
School ID
School Name
School Address
Grade From
Select Grade
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Grade To
Select Grade
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
SY From
SY To
Add JH & SH
PARENT/GUARDIAN BACKGROUND
Person to Notify Incase of Emergency:
Mother
Father
Guardian
MOTHER INFORMATION
First Name:
*
Mother's Maiden Name:
Last Name:
*
Extension Name:
Occupation:
*
Contact Number:
Email Address:
Home Address
City
FATHER INFORMATION
First Name:
*
Middle Name:
Last Name:
*
Extension Name:
Occupation:
*
Contact Number:
Email Address:
Home Address
City
GUARDIAN INFORMATION
First Name:
*
Middle Name:
Last Name:
*
Extension Name:
Occupation:
*
Contact Number:
Email Address:
Relationship:
*
Gender:
*
Select Gender
Male
Female
Home Address
City
OTHER INFORMATION
SUBMIT
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School Terms and Agreements
Terms and Conditions
×
DA5 Money Laundring Prevention Program
