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    20220713T035456547 Att 599051698303190

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    chayelesalvador10

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    20220713T035456547 Att 599051698303190

    Uploaded by

    chayelesalvador10
    6 views1 page

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    20220713T035456547.att.599051698303190

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    Copyright:

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    6 views1 page

    20220713T035456547 Att 599051698303190

    Uploaded by

    chayelesalvador10

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    PHILIPPINE SCIENCE HIGH SCHOOL SYSTEM

    CAMPUS: _________________________

    STUDENT INFORMATION SHEET

    School Year ______________

    PLEASE PROVIDE COMPLETE INFORMATION AND PRINT LEGIBLY:

    NAME: _______________________________________________________________ SEX: ___________________


    Surname Given Name Middle Name

    NICKNAME: _______________________ GRADE LEVEL: _____________ SECTION: ________________________

    BIRTHDATE:_________________ BIRTHPLACE: _____________________ RELIGION:_________________________

    NATIONALITY: ______________ CITIZENSHIP: ___________________ IF DUAL, PLS. SPECIFY __________________

    COMPLETE HOME ADDRESS


    HOUSE NO.: _________ STREET: __________________________ BARANGAY: ________________________

    TOWN/CITY: _______________ PROVINCE: _____________ CONGRESSIONAL DISTRICT: ____ ZIP CODE: ________

    TELEPHONE NO.: ______________CELLPHONE NO.: _________________ E-MAIL ADDRESS: _________________

    PREVIOUS SCHOOL ATTENDED _____________________________________________________________________

    SCHOOL ADDRESS: __________________________________________________ DATE OF GRADUATION ________

    NO OF GRADUATES _______ FINAL AVERAGE _______ HONOR/S RECEIVED _______________________________

    CONTACT PERSON/S DETAILS


    FATHER MOTHER
    NAME

    SPECIMEN SIGNATURE
    HOME ADDRESS (if different from
    above)
    TEL NO
    CITIZENSHIP
    CELLPHONE NO.
    E-MAIL ADDRESS
    OCCUPATION
    OFFICE

    OFFICE ADDRESS
    TEL. NO.

    GUARDIANS WHILE STUDYING AT PSHS- ___________________________:

    GUARDIAN GUARDIAN
    NAME
    SPECIMEN SIGNATURE
    RELATION TO STUDENT
    HOME ADDRESS
    TEL NO
    OFFICE ADDRESS
    TEL. NO.

    NOTE TO THE STUDENT/PARENT: Please notify the REGISTRAR’S OFFICE for any change in the above information
    during the school year.

    PSHS-00-F-REG-03-Ver02-Rev0-02/01/20

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