ATENEO DE MANILA UNIVERSITY

Loyola Schools

Office of the Registrar

STUDENT

▪Please fill in the details and submit the accomplished form to the Registrar's Office during enrollment

INFORMATION SHEET

▪Issuance of any document from the Registrar's Office requires submission of this Information Sheet.

(UNDERGRADUATE LEVEL)

▪If there are any subsequent changes in this information, please contact the Registrar's Office

Surname (in Birth Certificate)

First Name (in Birth Certificate)

Home Number

Mobile Number

E-mail Address

Civil Status

Birthdate (month/day/year)

Birthplace

Street

WEEKDAY

NOTE: Please leave this blank. To be filled out upon arrival in Manila.

ADDRESS

City/Municipality

Province

Street

WEEKEND

NOTE: Please leave this blank. To be filled out upon arrival in Manila.

ADDRESS

City/Municipality

Province

Are you residing with your parents? ___ Yes ___ No If no. please check one:___With Relatives ___ At Cervini/Eliazo

___ Off Campus Dorm/Condo ___ Others, specify____________

Street

MAILING HOME

ADDRESS

City/Municipality

Province

(Mr./Dr./Atty./Engr.,etc)

First Name

Occupation

Father's Name

E-mail Address

Mobile Number

Residence Address

(Ms./Mrs./Dr./Atty.,etc)

First Name

Occupation

Mother's Name

E-mail Address

Mobile Number

Residence Address

In an emergency, contact the following person:______________________

Emergency contact number:______________

Relationship:_____________________

FULL NAME AND LOCATION OF THE SCHOOL (Use back sheet if necessary)

School Year/s Attended

ELEMENTARY

Primary (Grades 1 to 3)

EDUCATION

Intermediate (Grades 4 to 6/7)

First Year

HIGH SCHOOL

Second Year

EDUCATION

Third Year

Fourth Year

COLLEGE

EDUCATION

(For Transferees)

I certify that, to my best knowledge, all the information is true and correct.

Student's Signature___________________________

Date:_________________