DOMUSCHOLA

INTERNATIONAL SCHOOL

1X1
PHOTO

Student Application Form

AO FORM NO. 001

APPLICATION
ADMISSIONS OFFICE

APPLICATION FORM FOR SCHOOL YEAR:

GRADE / LEVEL:
Kindly fill out all fields, put N/A for those that do not apply to you.

APPLICANT INFORMATION
Name of Child

SAM ANTON MIGUEL

FIRST NAME

MIDDLE NAME

LAST NAME

AGE:

DATE OF BIRTH:
NATIONALITY:

YRS:

NICKNAME

MOS:

SEX:

LANGUAGE/S SPOKEN:

RELIGION:

TELEPHONE NO./S:

HOME ADDRESS:

GRADE / LEVEL:

SCHOOL LAST ATTENDED:

PREVIOUS SCHOOLS ADDRESS:
ANY BEHAVIORAL CONCERN: YES:

NO:

If YES, please explain:

ANY LEARNING DISABILITY:

YES:

NO:

If YES, please explain:

HOW DID YOU KNOW ABOUT DOMUSCHOLA INTERNATIONAL SCHOOL?

FATHERS INFORMATION
NAME OF FATHER:

NICKNAME:

ADDRESS:

HOME PHONE:

DATE OF BIRTH:

RELIGION:

NATIONALITY:

EDUCATIONAL ATTAINMENT:

SCHOOL:

OCCUPATION:

WORK HOURS:

NAME OF COMPANY:

COMPANY ADDRESS:

WORK PHONE:

MOBILE NO.:

EMAIL ADDRESS:

OTHER CONTACT NO./S:

MOTHERS INFORMATION
NAME OF MOTHER:

NICKNAME:

ADDRESS:

HOME PHONE:

DATE OF BIRTH:

RELIGION:

NATIONALITY:

EDUCATIONAL ATTAINMENT:

SCHOOL:

OCCUPATION:

WORK HOURS:

NAME OF COMPANY:

COMPANY ADDRESS:

WORK PHONE:

MOBILE NO.:

EMAIL ADDRESS:

OTHER CONTACT NO./S:

If parents are not living together, which parent has custody of child?

Fathers Signature Over Printed Name

Mothers Signature Over Printed Name

Date

Once completed, please SAVE and submit the form via email to admissions@dis.edu.ph
or send it to the Admissions Office, DIS Campus.

FOR SCHOOL USE ONLY

Application received by:
Date received: