Senior High School Registration Form
Student Type
*
New Student
Old Student
Transferee
*
Indicates required fields
Student Personal Information
Last Name
*
Given Name
*
Middle Name
Date of Birth (Month, Day, Year)
*
SEX
*
Male
Female
AGE
*
Religion
*
Place of Birth (City/Town or Province)
*
Civil Status
*
Select Civil Status
Single
Married
Widowed
Separated
Contact Number
*
Must be exactly 11 digits
E-mail Address
*
LRN (Learner Reference Number)
(optional)
If provided, must be exactly 12 digits
Permanent Address
*
Home Address
*
Guardian Name
*
Guardian Contact Number
*
Must be exactly 11 digits
Guardian Relationship
*
Select Relationship
Parent
Father
Mother
Guardian
Relative
Other
Academic Year
*
Automatically set to current active school year
Term
*
Select Term
1st Semester
2nd Semester
Select term for 2025-2026
Elementary School Information
Elementary School Name
*
Address
*
Region
*
Are you a passer of Philippine Education Placement Test (PEPT) for Elementary Level?
*
No
Yes
Are you a passer of Accreditation and Equivalency (A&E) Test for Elementary Level?
*
No
Yes
Name of Community Learning Center
*
Address
*
Junior High School Information
JHS Name
*
Address
Region
Are you a passer of Philippine Education Placement Test (PEPT) for JHS Level?
No
Yes
Are you a passer of Accreditation and Equivalency (A&E) Test for JHS Level?
No
Yes
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