| PERPETUAL HELP COLLEGE |
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| 1240V.
Concepcion St., Sampaloc, Manila |
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| COLLEGE OF BUSINESS ADMINISTRATION |
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| STUDENT INFORMATION SHEET |
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| PERSONAL
BACKGROUND: |
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| NAME: __________________________, _______________________ ___________ |
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| Last Name First
Name Middle Name |
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| Permanent
Address: ____________________________________________________ |
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| Tel.#
: ___________________________ Sex: (pls. Check) ___ Male ___ Female |
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| Birthdate: _________________________ Status ___Single ___ Married ___ Widow |
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| Birthplace: _________________________ Religion:
_________________________ |
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| Father:
____________________________
Mother:
__________________________ |
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| Occupation:
________________________
Occupation:
_______________________ |
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| Address: __________________________ Address:
__________________________ |
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| __________________________________ __________________________________ |
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| Tel. #: ____________________________ Tel. #:
____________________________ |
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| PERSON TO
CONTACT IN CASE OF EMERGENCY:
____________________________ |
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| Address:
_____________________________________________________________ |
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| __________________________________ Tel. #:
____________________________ |
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| EDUCATIONAL
BACKGROUND: |
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School Name & Address |
Year |
Awards |
| Elementary |
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| High School |
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| College |
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| Vocational |
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| Technical |
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| EXTRA-CURRICULAR
ACTIVITIES: |
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Organization Name |
Year |
Position |
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| Elementary |
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| High School |
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| I swear that all information printed in
this form are true and correct. I
further bind myself |
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| upon admission
to comply with the PHCM school policies, rules and regulations. |
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_______________________ |
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Student Signature |
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| PARENT OR
GUARDIAN'S CONSENT |
| I, ___________________________FATHER/
MOTHER/ GUARDIAN, of the above applicant |
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| do hereby give
my consent for him/ her to enroll at PERPETUAL HELP COLLEGE-MANILA. |
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_______________________ |
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Signature of Parent/Guardian |
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