Senior High School

[Pages:7]Senior High School

Application No.

APPLICATION FOR ADMISSION SY 2019-2020

Important: Applicants may take the entrance test for Grade 11 only once.

PLEASE PRINT LEGIBLY. Write N/A if the required information is not applicable.

NAME OF APPLICANT:

________________________________________________________________________________________________________________

(Name on Birth Certificate) LAST NAME

GIVEN NAME

MIDDLE (Give Full Middle Name)

HOME ADDRESS _____________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

TEL / MOBILE # ___________________________________________

E-MAIL ADDRESS ____________________________________

DATE OF BIRTH _________________________________

DO NOT WRITE BELOW THIS LINE. ---------------------------------------------------------------------------------------------------------------------------------

APPLICATION CHECKLIST:

Official Receipt No.

Photocopy of Grade 10 Report Card for the first grading period of SY 2018-2019

Photocopy of Final Grade 9 Report Card with complete grades for SY 2017-2018

Two (2) recent ID pictures (1" x 1") in COLOR -- Paste one ID picture on the Application Form. Clip the other ID picture to the Application Form using a paper clip. (The second ID picture will be pasted on the A-SHAPE test permit when it is issued.)

Clear photocopy of applicant's Birth Certificate (Philippine Statistics Authority Copy)

i. If applicant is not a Filipino citizen, submit a photocopy of his (1) Alien Certificate of Registration (ACR) and (2) a Special Study Permit issued by the Bureau of Immigration.

ii. If applicant has dual citizenship, submit a photocopy of his Philippine Passport or Certificate of Recognition as a Filipino Citizen.

Two (2) Letters of Recommendation from the last school attended (The persons recommending you may submit a recommendation letter or may use the recommendation form available in the ASHS website.)

Handwritten or typewritten autobiography on size A4 bond

*Applicants enrolled abroad will be required to submit a certificate of eligibility for admission to Grade 11 (issued by the Philippine Department of Education) upon acceptance and enrollment in the ASHS.

NOTE: Only applications with complete requirements will be processed.

Please paste ONE

1x1 ID photo here. Clip the 2nd 1x1

photo to this form

using a paper clip. (2nd photo is for the exam permit)

Senior High School

APPLICATION FOR ADMISSION SY 2019-2020

Application No.

Credentials filed in support of this application become the property of the Ateneo de Manila University and will not be returned to the applicant.

PERSONAL INFORMATION

(PLEASE PRINT LEGIBLY)

LEGAL NAME _______________________________________________________________________________ LRN _________________________

(Name on Birth Certificate) LAST NAME

GIVEN NAME

MIDDLE NAME

CURRENT SCHOOL ________________________________________________________________ (Please check.) Public Private

HOME ADDRESS _____________________________________________________________________________________________________________

ZIP CODE ____________ GENDER Male Female TEL / MOBILE # ___________________________________________ E-MAIL ADDRESS ____________________________________ CITIZENSHIP _____________________ RELIGION ____________________

DATE OF BIRTH _________________________________ PLACE OF BIRTH _______________________________________________________

FATHER'S NAME _______________________________________________________________ Living ( ) Deceased ( )

HOME PHONE # ______________________ MOBILE # __________________________ E-MAIL ADDRESS ________________________ OCCUPATION ____________________________ EMPLOYER/BUSINESS NAME ____________________ TEL/FAX _______________ EMPLOYER'S/BUSINESS ADDRESS ______________________________________________________________________________________

MOTHER'S NAME _______________________________________________________________ Living ( ) Deceased ( )

HOME PHONE # ______________________ MOBILE # __________________________ E-MAIL ADDRESS ________________________

OCCUPATION ____________________________ EMPLOYER/BUSINESS NAME ____________________ TEL/FAX _______________ EMPLOYER'S/BUSINESS ADDRESS ______________________________________________________________________________________

PARENTS ARE ( ) Together ( ) Separated ( ) Widowed ( ) Not Married ( ) Marriage Annulled

APPLICANT LIVES WITH

( ) Both parents ( ) Father

( ) Mother

( ) Guardian

GUARDIAN'S NAME (if any) ____________________________________________________ Relation to Applicant ____________________

HOME PHONE # ____________________ MOBILE # __________________________________ E-MAIL ADDRESS ___________________ OCCUPATION _____________________________ EMPLOYER/BUSINESS NAME ____________________ TEL/FAX _______________ EMPLOYER'S/BUSINESS ADDRESS _______________________________________________________________________________________

NAMES OF BROTHERS / SISTERS OF APPLICANT AGE

SCHOOL / OCCUPATION

SCHOLASTIC BACKGROUND

List all schools you attended beginning from the lowest grade:

Name of School

Location

From Grade

To Grade

From SY

To SY

Have you ever applied to the Ateneo High School prior to this application? [ ] YES [ ] NO

If YES, when? _______________ For what grade/year level? _______________

(A separate sheet of paper may be used for this portion.)

List all your extra-curricular activities, including positions held.

List any honors or awards you have received for scholastic achievement

and deportment.

List your community or church activities.

Considering your academic aptitude, skills, and career interests, which strand would you like to be placed in if

you are accepted to the Ateneo? Please rank the strands from 1 (as your 1st choice) to 4 (as your last choice).

Note that your strand assignment may not be your 1st choice.

[ ] Accountancy, Business & Management

[ ] Science, Technology, Engineering & Mathematics

[ ] Humanities and Social Sciences

[ ] General Academic

Were you ever dismissed from any school or denied re-admission? [ ] YES [ ] NO If YES, provide name of school, school year and reason/s. _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________

Did you ever repeat a grade/year? [ ] YES [ ] NO If YES, provide name of school, school year and reason/s. _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________

Were you ever placed on probation status? [ ] YES [ ] NO If YES, provide name of school, school year and reason/s. _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________

Name of the Principal, Headmaster or Director of your present school _____________________________________

AUTOBIOGRAPHY

Please write a brief autobiography touching on the following points: your chief interests, ambitions, accomplishments, and your desire for a high school education at the Ateneo de Manila University. The autobiography should be handwritten or typewritten on size A4 bond paper and should be only 1-2 pages long.

This is an important part of your application and a good opportunity to make yourself known to the Committee on Admission and Aid. Take time to think about what you will write and give attention to the fundamentals of good writing (content, organization, and mechanics such as grammar and spelling). Make sure not to simply repeat information already provided in other pages of this form.

RECOMMENDATIONS

Give the names and addresses of the persons who gave you Letters of Recommendation. Make sure you chose two (2) persons who know you well and who have held positions of authority over you in your present school (ex. teacher, counselor or principal). Do not include relatives or friends.

Name _____________________________ Position ____________________ Address ______________________________________

Name _____________________________ Position ____________________ Address ______________________________________

CERTIFICATION

We hereby certify that all information supplied in this application is accurate and complete and we authorize Ateneo Senior High School to verify all information supplied herein.

We consent to allowing the Ateneo Senior High School Office of Admission and Scholarships to use, share and disclose data in this form for purposes related to this application.

We fully understand that misrepresentation of information supplied herein will be considered sufficient reason both for refusal of admission and exclusion.

Father's/Guardian's Signature ________________________ Mother's/Guardian's Signature ____________________

Applicant's Signature ___________________________________ Date _________________________

Last Name

First Name

Middle Name

DO NOT WRITE BELOW THIS LINE ---------------------------------------------------------------------------------------------------------------------------------

Date Application Received ____________________

Date of Decision

____________________

Date of Notification

____________________

Action of the Committee on Admission and Aid:

[ ] Accepted in [ ] ABM [ ] HUMSS [ ] STEM [ ] GA [ ] Wait-listed [ ] Rejected

Remarks

Ateneo Senior High School Recommendation Form

Application for Grade 11

SY 2019-2020

TO THE APPLICANT: You need two letters of recommendation sealed in letter envelopes to complete your application requirements. The person you choose to recommend you should hold a position of authority over you (e.g. teacher, advisor, counselor) and should know you well enough to provide the school with a helpful evaluation of your strengths and/or areas for improvement. The persons recommending you may submit a recommendation letter or may use this form.

Write your name below using ink. Provide the person recommending you with a letter envelope.

NAME ______________________________________________________________________________________________________________

(On birth certificate)

LAST NAME

FIRST NAME

MIDDLE NAME

TO THE PERSON RECOMMENDING: The student whose name appears above is applying for admission to the Ateneo Senior High School. Your candid assessment of this student will assist the Admissions Committee in evaluating this student's applicaton. Please fill out this form completely. When you have filled out this form, please seal it in a letter envelope and sign across the flap before returning it to the applicant. All information will be kept confidential. -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------Please check the box that is applicable.

Intellectual Ability

Oral Communication Skills Written Communication Skills

Motivation

Consistency of Performance

Adaptability

Above Average

Average

Below Average

No Chance To Observe

Leadership Potential

Please provide any information you think would help the Admissions Committee better understand the applicant. _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________

OVERALL RECOMMENDATION:

_____ Strongly Recommended _____ Recommended With Reservation*

_____ Recommended _____ Not Recommended*

*Please state your reason/s on the lines below or on a separate sheet. _________________________________________________________________________________________________________

_________________________________________________________________________________________________________

RECOMMENDER'S FULL NAME: _________________________________________ DESIGNATION: ________________________ CONTACT DETAILS: PHONE NUMBER/S: ____________________________ E-MAIL ADDRESS: ___________________________ HOW LONG HAVE YOU KNOWN THE APPLICANT? ____________________ IN WHAT CAPACITY? __________________________ RECOMMENDER'S SIGNATURE: ______________________________________

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