ST. MARY'S ACADEMY OF STA. ANA
  REGISTRATION FOR OLD STUDENTS for SY 2022-2023                                                                          REG-FO-027
Email *
STUDENT ID# *
LEARNER REFERENCE NUMBER (LRN) *
LEARNER'S FULL NAME (Surname, First Name, Middle Name)                                                                                                 *
Grade Level (k-10) *
Name of Siblings studying at SMASA and Grade Level *
Name of Relatives who studied/graduated at SMASA (Please indicate their Batch Year) *
PERMANENT ADDRESS (House number, Street, Brgy, City) *
DATE OF BIRTH *
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/
DD
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YYYY
GENDER *
FATHER'S FULL NAME (Surname, Full Name, Middle Name) *
FATHER'S EMAIL ADDRESS *
MOTHER'S FULL NAME (Surname, First Name, Middle Name) *
MOTHER'S EMAIL ADDRESS *
LEGAL GUARDIAN *
LEGAL GUARDIAN'S EMAIL ADDRESS *
CONTACT NUMBER (Parent's & Guardian) *
PERSON TO NOTIFY IN CASE OF EMERGENCY *
CONTACT NUMBER *
ADDRESS *
PAYMENT FOR: PAYMENT FOR: (To be officially enrolled, kindly email the official receipt or proof of payment to cashier@smasa.edu.ph) *
We, the Undersigned Parties, do hereby bind ourselves to the following terms of this Contract:
 ON THE PART OF THE STUDENT:   That I agree to study at St. Mary’s Academy, Sta. Ana Manila (SMASA), 2318 Pedro Gil Street, Sta. Ana, Manila; provided that I meet all requirements for enrolment. That I will abide by the rules and regulations of the SMASA; that I will comply with the school requirements and finish the course for each school year, applying myself with seriousness and dedication; and that I will consult the school authorities on problems relative to the fulfillment of the terms of this contract.
           
ON THE PART OF THE PARENT/GUARDIAN:  That as the parent/guardian of the aforesaid student, I fully agree to enroll my child/ward at SMASA; that I will abide by the rules of the school; that I will help my child/ward to finish the course for every year level during the
period specified; that I will help in the best way I can in:  a) preventing truancy and/or absenteeism of my child ward; b) making my child/ward attend seriously to his/her school work;  and  c) attending/participating in school activities that need my presence.

That if my child/ward transfers or withdraws before or after the beginning of classes and has already paid the pertinent tuition and other fees, I will be charged as specified:        
 1) 10% of the total amount paid if my child/ward withdraws within the first week of classes; 2)20% of the total amount paid if my child/ward withdraws within the second week of classes; 3) NO refund paid if my child/ward withdraws within the third and fourth week of classes  and;   4) Charged in FULL of  the total amount due if my child/ward withdraws after the fourth week of classes.
   
    That in case of problems relative to the fulfillment of this contract, I will consult the school authorities concerned.
     
    ON THE PART OF THE SCHOOL: That St. Mary’s Academy of Sta. Ana, Manila will give the same attention and training to all students enrolled in the school; that in case of problems relative to this contract, the parents/guardians will always be consulted.  

We, the Undersigned Parties, do hereby bind ourselves to the following terms of this Contract: *
DATA PRIVACY NOTICE
Disclaimer & Confidentiality: The information collected will be used by the school as part of the learner's application for pre-enrollment or reservation for School Year 2021-2022. All the data collected will be treated with utmost confidentiality in compliance with R.A. 10173 or the Data Privacy Act of 2012.
A copy of your responses will be emailed to the address you provided.
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