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Department of Education Region X Division of Bukidnon Sumilao District SAN VICENTE NATIONAL NATIONAL HIGH SCHOOL
San Vicente, Sumilao, Bukidnon
Senior High School Enrolment Form Semester
SY
-
School Name: Address: School ID
TO THE STUDENTS AND PARENT/GUARDIAN: Print legibly all information required. Submit accomplished form to the Senior High School (SHS) Focal Person. I. STUDENT INFORMATION 1. EARNER REFEREN!E NUM"ER #RN$
%. NAME OF STUDENT: Print or type full name in the following sequen ce !"S#$ F%&S#$ '%!$ *#+S%,+ +"' (if any). Place one letter in each bo. !eae one bo blan/ between names. names.
&. AGE:
'. SE(
*. DATE OF "IRTH #'onth$ ay$ Year)
+. "elonging to )n, In-igeno Peo0le #IP$ Gro0
2
2
Yes
M)le
Fem)le
+o
0. PERMANENT HOME ADDRESS House +umber and Street Subdiision12arangay 3ity1'unicipality Proince
Postal14ip 3ode
3ountry
3. PARENT/S or GURADIAN4S NAME 'other5s +ame Father5s +ame 6uardian5s +ame 5. !ONTA!T INFORMATION #elepho #elephone ne +umber +umber
3ellphone 3ellphone +umber +umber
mail "ddress 16. 7UNIOR HIGH S!HOO #7HS$ %ndicate where student completed fourth year high school16rade 78. Fill on only the boes APPI!A"E. i. 7HS N)me #o not abbreiate)
Month/8e)r o9 !om0letion
A--r e #3ity1'unicipality$ 3ity1'unicipality$ Proince and 3ountry)
ii. Phili00ine E-c)tion)l Pl)cement Tet #PEPT$ 9or 7HS
Month/8e)r o9 !om0letion !erti9ic)te No:
iii. Accre-it)tion )n- Ei;)lenc, #A
Month/8e)r o9 !om0letion
;. N)me o9 o9 !ommnit, !ommnit, e)rning !enter #o not ab abbreiate)
A--re (3ity1'unicipality$ (3ity1'unicipality$ Proince and 3ountry)
II. SENIOR HIGH S!HOO #SHS$ PROGRAM: 'a/e sure that the trac/ ("cademics$ #echnical-9 #echnical-9ocational-!ie ocational-!ielihood lihood (T= (T=)$ )$ Sports$ "rts and esign)$ strand (S#'$ "2'$ H:''S and 6"S)$ or #9! speciali;ation choices are offered in the school. < rite the 3,'P!# programing offering (trac/ = strand or speciali;ation1s) of your choice in the bo proided. PROGRAM #Tr)c> ? Str)n- or S0eci)li@)tion/$:
% understand that all information % proide in this form may be used by the epartment of ducation and % consent to such with the assurance that personal details will be /ept confidential.
Signature oer Printed +ame of the Student
a ate
Signature oer Printed +ame of the Parent16uardian
ate
&equirements for SHS nrolment are as follows 7. 3ompletion of 6rade 78 in a Public or Priate Secondary School before >87?@ >. ocumentary requirements$ including a. uly "ccomplished SHS nrolment Form b. 2irth 3ertificate c. &eport 3ard$ Form Form 7AB or any documentary proof proof of completion completion of 6rade 6rade 78 in a public or priate secondary school. A. Philippines ducational Placement test (PP#) and "ccreditation and quialency #est ("C) passers and those graduates form non accredited priate schools who passed the Philippine 9alidation 9alidation #est #est (P9#) should bring their certificates.
