St.

Scholastica’s College (SSC)

Manila
APPLICATION FOR ADMISSIONS TO COLLEGE

Last Name

First Name

Middle Name

Tel. No: Beeper: Cellular phone:

Home/Mailing Address:
House No. Street Village Area/District

City/Prov. E-mail
Name of High School
Address of School Date of Grad.
Paste
Date of Birth Place of Birth 2” x 2”
Age Nationality Religion Picture
Pls. Shade: Sex: Female Male Civil Status: Single Married
Date of Baptism Place of Baptism
Schools Attended:

Level School Place Date of Attendance

Prep
GS

HS

Guardian (if not living with parents)

Last Name First Name
Middle Name Relationship
House No. Street Village Area/District
City/Prov. E-mail Tel. No.

Family members who are studying or who have studied in SSC:

Grade/Year presently enrolled
Name Relationship Course or Year Graduated
_______________________________ __________________________ ____________________________ __________________________
_______________________________ __________________________ ____________________________ __________________________
_______________________________ __________________________ ____________________________ __________________________

My mother grandmother great grandmother was a graduate of SSC, Manila: Yes No

Course applied for: First Choice ____________________________________ Second Choice _____________________________
Pls. Shade: Course applied for is: My choice My parents Choice of school is: : My choice My parents
Recommended by _____________________________________ Recommended by _____________________________________
Other colleges/universities to which you are applying (for SSC purposes only)

Reasons for being interested in / or having chosen SSC?

FAMILY DATA: (Mark + if deceased)
Father Mother

_____________________________________________ Last Name _______________________________________________

_____________________________________________ First Name _______________________________________________
_____________________________________________ Middle Name _______________________________________________
- - Age, Birthday - -
____________________ ________________________ Nationality, Religion ____________________ _______________________
__________ __________________________________ House No., Street __________ ___________________________________
____________________ ________________________ Village, Area ______________________ ________________________
____________________ ________________________ City, Tel. No. _______________________ _____________________
____________________________ Zip Code, E-mail _________________________________
______________________________________________ Occupation ___________________________________________________
__________________________ ________________ Business Address / Tel. No. ________________________ ________________
_____________________________________________ Educ. Attainment _____________________________________________
____________________________________________ School grad. from ______________________________________________
Pls. Shade Marital Status: Married and living together Separated Widowed Widowed, remarried
Mailing Address: Home Address Father’s Address Mother’s Address Guardian’s Address
Brothers/Sisters (SSC/non-SSC)
Last Name First Name Age Course/Occupation School/Business/Office

FOURTH YEAR GRADES

1st qtr 2nd qtr 3rd qtr 4th qtr AVE
English Since each school has its own grading system, please submit a certificate
Math from your Principal/Registrar of your school’s grading system with its
Science corresponding interpretation together with this application form.
Final AVE

This is to affirm that all information provided in the application form are complete and accurate. Any information may be checked
against original documents or with the respective school officials and that withholding or giving false information will disqualify me from
admission to SSC.

I further affirm that I have not enrolled in any other college or university and have not taken any college subject.

This is to certify that I share with my child/dependent the

responsibility for the veracity and completeness of the information
supplied in this application form.
____________________________________ ___________________________________
Signature of Applicant Signature of Parent/Guardian

Application # __________ CREDENTIALS SUBMITTED (Requirements for Graduation or for Honorable Dismissal):
Date Applied __________ _____________ Birth Certificate
Date Submitted________ _____________ Form 137
O.R. # _______________ _____________ Transfer Credentials (Honorable Dismissal)
Date of Test ___________
Action Taken __________
_____________________ GRANTED TRANSFER CREDENTIALS effective ________________________
_____________________
_____________________ COPY OF FORM 137 SENT TO _______________________________________
_____________________ __________________________________________________________________
_____________________
Address: __________________________________________________________

Noted by: _______________________________ _________________________

Registrar’s Signature Date
Admissions & Grants Officer

That In All Things God May Be Glorified

U.I.O.G.D.