Generated: February 5, 2020 - 03:17:04 pm

Admission Information - 26774 - February 17, 2020

Entry: New Type: K12 (SHS Graduate) Applicant Type: Filipino
Strand: STEM LRN: 128302070067
Preferred Courses
1st Choice: 2nd Choice: 3rd Choice:
Bachelor of Science in Civil Bachelor of Science in Electrical Bachelor of Science in Criminology
Engineering (BSCE) Engineering (BSEE) (BS Crim)

Personal Information
Name: Jumao-as, Diosdado Villanueva Sex: Male
Address: Nepal St. ,Salawag,Dasmariñas,Cavite,4114
Email: diovanjumaoas@gmail.com Mobile#: 09167741876
Birthdate: 2001-10-26 Nationality: Filipino Civil Status: Single
Family Background
Contact Occupation
Father: Diosdado A. Deceased
Jumao-as Jr.
Mother: Evangeline V. 09128611213 Self-employed
Jumao-as
Guardian: Dionne Trecia V. 09497249133 Call Center Agent
Jumao-as
Educational Background
Elementary
Apokon Elementary School Apokon, Tagum City, Davao Del 2014 Public
Norte
High School
Sagayen National Highschool Sagayen, Asuncion, Tagum City, 2018 Public
Davao Del Norte
Senior High School
St. Jude College Carlos Trinidad Avenue, Salitran 2020 Public
IV, City Of Dasmariñas, Cavite
Medical History Information
Medications: 0 To be filled up by the OSAS/Guidance Staff
Medical Exam date and time:

Condition/s: SUBMITTED REQUIREMENTS

I hereby certify that all the information stated above are true and __ 2 copies of 1x1 ID Picture
correct as to the best of my knowledge. I hereby give consent for my __ Short ordinary white folder
personal data included in my offer to processed for the purposes of New Student (SHS,ALS)
admission and enrollment in accordance with Republic Act 10173 - __ Photocopy HS or SHS Form 138/Certificate of ALS Rating
Data Privacy Act of 2012. __ Photocopy Certificate of Good Moral Character
Transferee / Second Courser
__ Photocopy Transcript of Records/Certificate of Grades
__ Photocopy Transfer Credentials/Honorable Dismissal
__ Photocopy Certificate of Good Moral Character
Signature over printed name __ Photocopy NBI Clearance
__ Photocopy Interview Slip
Second Courser
__ Photocopy Transcript of Records
__ Photocopy Interview Slip
 Assessed by:___________________________
Control No.:A20-1-_____________

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