Name

GRADE LEVEL AND FORMER SCHOOL INFORMATION

Entry Status *

Grade Level to enroll: *

Learner Reference Number (LRN)

School Year *

Last School Year Completed: *

Last Grade Level Completed *

Check the appropriate box only *

With LRN

Without LRN

STUDENT INFORMATION

Last Name *

First Name *

Middle Name *

EXTENSION NAME e.g. Jr., III (if applicable)

Date of Birth *

Age *

Gender *

Address *

Belonging to Indigenous Peoples (IP) Community/Indigenous Cultural Community

Yes

Mother Tongue

Religion

PARENT/ GUARDIAN INFORMATION

Father

First Name *

Middle Name

Last Name *

EXTENSION NAME e.g. Jr., III (if applicable)

Vital Status *

Mother

Full Maiden Name

First Name *

Middle Name

Last Name *

Vital Status *

Emergency Contact Person *

Father

Mother

Guardian

CONFORME

We agree to abide by the rules and regulations of the La Trinidad Nazarene Learners Center (LTNLC) and to settle/ fulfill all accounts/ obligations it requires.

We agree to recognize LTNLC’s sole prerogatives to promulgate such reasonable rules and regulations it deems necessary for the effective implementation of its educational philosophy and that should we disagree, we agree to voluntarily withdraw our enrolment in the school and hold it free from liabilities.

We understand that the enrolment in LTNLC is for the entire school year, for which we are bound to pay the total tuition fee even in case of withdrawal or transfer, regardless of reason and time.

We conform to the policy that tuition, computer education, miscellaneous and textbook fees are non-refundable and non-transferable and that textbooks should not be reproduced.

We are aware that non-submission of or deficiency in admission & enrolment requirements is a ground for non-admittance to or withdrawal from LTNLC.

Agree

I AGREE

I DISAGREE

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