ENROLLMENT APPLICATION – DISTANCE LEARNING/HOMESCHOOL PROGRAM

Note: Please fill up all in “CAPITAL LETTERS” using PC/LAPTOP or TABLET/IPAD

Date Submitted JULY 27, 2020
Type of Program DISTANCE LEARNING PROGRAM
Grade/ Level 3
School Year 2020-2021
Last Name SANTIAGO
Middle Name JAMLANG
First Name ANIKA ZERINE
“Nickname” ANIKA
Email Address (case sensitive) azsantiago26@gmail.com
Telephone No.
Mobile No.
Citizenship/Nationality FILIPINO
Gender FEMALE
Civil Status S
Religion CATHOLIC
Birth date MARCH 26, 2012
Age 8
Country PHILIPPINES
Complete of BLK. 17 LOT 26 CAMELLA NUEVA ECIJA BRGY VALLE CRUZ CABANATUAN
Address Student CITY
Name of SHERRE JAMLANG
Parents/Guardian
Complete Address of SAME AS THE STUDENT
Parents/Guardian
Mobile No. of Parents 0923-733-1450
Email address of Parents/Guardian sjamlang@gmail.vom

Name of Previous School Attended SCHULLER CHRISTIAN ACADEMY

Grade/Level in Previous School 2
Year of Latest school attended 2020

For distance learning Zoom or skype account: azsantiago26@gmail.com

program