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JUNIOR HIGH SCHOOL

Basic Information

Student ID Number:

Student's LRN:

* Last Name:

* First Name:

Extention Name: Ex.(Jr., II, III)

Middle Name:

* Sex:

* Birthday: mm-dd-yyyy

* Religious Affiliation:

* Place of Birth:

Number of Siblings:

* Mobile Number:

* Email Address:

Current Address

* House No. / Street / Sitio / Purok & Barangay:

* Municipality / City:

* Province:

Father's Information

* Father's Name:

Occupation:

* Mobile Number:

* Email Address:

Mother's Information

* Mother's Name:

Occupation:

* Mobile Number:

* Email Address:

Guardian's Information

Same as Mother

Same as Father

* Guardian Name:

* Relationship:

Contact Number of Parent or Guardian

Landline Number:

* Mobile Number:

Other Information

* Status:

* Last School Attended:

* Incoming Grade Level:

* Are you an ESC Grantee?

* reCAPTCHA

Your responses will be kept confidential and will not be shared with any other party. These will be used solely for enrollment purposes only.

JCKL ACADEMY, INC.