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St. Scholasticas College (SSC)

Manila APPLICATION FOR ADMISSIONS TO COLLEGE

Last Name

First Name

Middle Name

Tel. No: Beeper: Cellular phone:

Home/Mailing Address:

House No. Street Village Area/District

City/Prov. E-mail

Paste2 x 2Picture

Name of High School

Address of School Date of Grad.

Date of Birth Place of Birth

A

ge Nationality Religion

Pls. Shade: Sex: Female Male Civil Status: Single Married

Date of Baptism Place of Baptism

Schools Attended:

Level School Place Date of Attendance

PrepGS

HS

Guardian ( if not living with parents )Last Name First Name

Middle Name Relationship

House No. Street Village Area/District

City/Prov. E-mail Tel. No.

Family members who are studying or who have studied in SSC:Grade/Year presently enrolled

Name Relationship Course or Year Graduated_______________________________ __________________________ ____________________________ _________________________________________________________ __________________________ ____________________________ _________________________________________________________ __________________________ ____________________________ __________________________

My mother grandmother great grandmother was a graduate of SSC, Manila: Yes No

C

ourse applied for: First Choice ____________________________________ Second Choice _____________________________

Pls. Shade: Course applied for is: My choice My parents Choice of school is: : My choice My parentsRecommended by _____________________________________ Recommended by _____________________________________

Other colleges/universities to which you are applying (for SSC purposes only)

Reasons for being interested in / or having chosen SSC?

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FAMILY DATA: (Mark + if deceased)

Father Mother

_____________________________________________ Last Name _______________________________________________

_____________________________________________ First Name _______________________________________________

_____________________________________________ Middle Name _______________________________________________

- - Age, Birthday - -

____________________ ________________________ Nationality, Religion ____________________ _______________________

__________ __________________________________ House No., Street __________ _______________________________________________________ ________________________ Village, Area ______________________ ________________________

____________________ ________________________ City, Tel. No. _______________________ _____________________

____________________________ Zip Code, E-mail _________________________________

______________________________________________ Occupation ___________________________________________________

__________________________ ________________ Business Address / Tel. No. ________________________ ________________

_____________________________________________ Educ. Attainment _____________________________________________

____________________________________________ School grad. from ______________________________________________

hade Pls. S Marital Status: Married and living together Separated Widowed Widowed, remarried

Mailing Address: Home Address Fathers Address Mothers Address Guardians Address

Brothers/Sisters (SSC/non-SSC)Last Name First Name Age Course/Occupation School/Business/Office

FOURTH YEAR GRADES1st qtr 2nd qtr 3rd qtr 4th qtr AVE

English Since each school has its own grading system, please submit a certificateMath from your Principal/Registrar of your schools grading system with itsScience corresponding interpretation together with this application form.

Final AVE

This is to affirm that all information provided in the application form are complete and accurate. Any information may be checked against original documents or with the respective school officials and that withholding or giving false information will disqualify me fromadmission to SSC.

I further affirm that I have not enrolled in any other college or university and have not taken any college subject.

This is to certify that I share with my child/dependent theresponsibility for the veracity and completeness of the informationsupplied in this application form.

____________________________________ ___________________________________Signature of Applicant Signature of Parent/Guardian

Application # __________Date Applied __________Date Submitted________O.R. # _______________Date of Test ___________Action Taken ____________________________________________________

_______________________________________________________________

CREDENTIALS SUBMITTED ( Requirements for Graduation or for Honorable Dismissal):_____________ Birth Certificate_____________ Form 137_____________ Transfer Credentials (Honorable Dismissal)

GRANTED TRANSFER CREDENTIALS effective ________________________ COPY OF FORM 137 SENT TO _________________________________________________________________________________________________________ Address: __________________________________________________________

Noted by: _______________________________ _________________________Registrars Signature Date

Admissions & Grants Officer

That In All Things God May Be Glorified U.I.O.G.D.