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LEARNER'S PERSONAL DATA *


School Group *
Entry Classification: *
Grade Level Applied for: *
Program/Strand: *
Program : *
School Year:	2024
Surname: *
First Name: *
Middle Name:
Sex: *	Male Female
Date of Birth: *
Place of Birth *
Religion *
Nationality *
Contact Number *
E-mail Address *
E-mail Verification Code *		Once you entered your e-mail, click the Send Verification Code button. You'll receive a confirmation e-mail on your indox or spam folder. Copy and paste it on the place holder. You may resend another verification code after a minute.

Present Address: *

Permanent Address: *

Click if the same as your present address


	First Name *
	Middle Name
	Surname *
	Nationality *
	Religion *
	Educational Attainment *
	Occupation *
	Name of Workplace *
	Is the father an alumnus of Assumption Iloilo? (If yes, kindly indicate the year graduated. If no, kindly type N/A) *


	First Name *
	Middle Name
	Surname *
	Nationality *
	Religion *
	Educational Attainment *
	Occupation *
	Name of Workplace *
	Is the Mother an alumna of Assumption Iloilo? (If yes, kindly indicate the year graduated. If no, kindly type N/A) *


	Full name *
	Sex *	Male Female
	Relationship to the Applicant *
	Contact Number *
	Email Address *

Reason for being interested in or having chosen Assumption Iloilo

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	By clicking this, I am allowing Assumption Iloilo to collect my personal and sensitive information to be used as a basis whether I will be accepted or not for admission to the program I am applying for. I understand that any misrepresentation/ false information above will result to cancellation of my admission/ enrollment.



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