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Kalayaan College: Application Form

The document appears to be an application form for Kalayaan College that requests personal information such as name, address, education history, family background, and financial information. Applicants must also submit requirements like transcripts and certificates depending on if they are applying as a freshman or transfer student. The form requires signatures certifying the truth and accuracy of the information provided.

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Julien Olisa
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103 views2 pages

Kalayaan College: Application Form

The document appears to be an application form for Kalayaan College that requests personal information such as name, address, education history, family background, and financial information. Applicants must also submit requirements like transcripts and certificates depending on if they are applying as a freshman or transfer student. The form requires signatures certifying the truth and accuracy of the information provided.

Uploaded by

Julien Olisa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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``` Kalayaan College Clip two (2) 2”x2”

APPLICATION FORM photograph taken within


22 Manga Road cor. Aurora Boulevard, the last 6 months.
New Manila, Quezon City
Sign your name on the back
of each photograph.
PRINT in ink or TYPE legibly. Submit together with the requirements cited below.
ONLY APPLICATIONS ACCOMPLISHED COMPLETELY WILL BE PROCESSED.

Requirements:
For Freshman Students For Transfer Students
Original copy of Fourth year Report Card Official Transcript of Records
Certificate of Graduation Honorable Dismissal
Birth Certificate
Birth Certificate Birth Certificate

Application is made as a: Freshman Student Transfer Student 2nd Undergraduate degree


Application is made for: 1st Semester 2nd Semester _______School Year

PROGRAM CHOICES for Degree Program / Course:


First Choice

Second Choice

Third Choice

PERSONAL DATA. Place one letter in each box. Leave one box blank between names.
Last Name

First Name

Middle Name

Permanent Mailing Address

Telephone #
Email Address

Sex: Male Female Civil Status: Single Married (Name of spouse)

Citizenship Filipino Non-Filipino (Specify)

Date of Birth - - Place of Birth


Year Month Day

HIGH SCHOOL (Where you completed/are completing secondary level education):


Name of School (Do not abbreviate) Address (City/Town, Province) Expected / Date of Completion

SCHOOLS ATTENDED (List in chronological order all the schools attended starting from primary school)
Educational Level Name and Address Dates Attended
__________________________ ___________________________________________ ____________________________
__________________________ ___________________________________________ _______ _____________________
__________________________ ___________________________________________ _______ _____________________
__________________________ ___________________________________________ ____________________________
__________________________ ___________________________________________ _______ _____________________
HONORS/AWARDS/DISTINCTIONS RECEIVED
_________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________

FAMILY BACKGROUND

FATHER MOTHER GUARDIAN


Name
Mailing Address
Email Address
Occupation
Name of Employer
Business Address
Office Telephone #

Annual Gross Family Income

Person to be notified in case of emergency:

Name: _________________________________________________________ Relationship: ______________________

Address: __________________________________________________________________________________________

Telephone #: ____________________ Mobile #: ______________________ Email Address: ______________________

MEANS OF FINANCIAL SUPPORT

Parents Self Loan Scholarship Educational plan, specify: ______________________

If self-supporting, state annual gross income _______________________ Present Occupation ______________________

Business address: ___________________________________________________________________________________

CERTIFICATION

A. I affirm that:
1. I have read and understood all instructions relevant to my application.
2. All the information supplied in this application form is true, complete and accurate.
3. I am aware that the information furnished in this application may be checked against original documents and that
withholding or giving false information will disqualify me from admission/will be a basis for dismissal, if
admitted.

___________________ __________________________________________
DATE SIGNATURE OF STUDENT

B. I certify that the information furnished in this application form by my son/daughter/dependent is true, complete, and
accurate. I recognize that in signing this application form, I share with my son/daughter/dependent the responsibility
for the veracity and completeness of the information supplied herein.

___________________ __________________________________________
DATE SIGNATURE OF PARENT/GUARDIAN

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