ACLC COLLEGE OF APALIT INC.

The Manansala Bldg. Brgy. Sulipan, Apalit, Pampanga

REGISTRATION FORM
Form No. USN DATE:

School Year 2021-2022 Admission's Officer use only

Sem 1st Sem Year Level: 1st Year

LAST NAME

FIRST NAME

MIDDLE NAME EXTENSION

MIDDLE NAME
INITIAL (ex. Jr. Sr.)

DATE OF BIRTH
AGE GENDER

PLACE OF BIRTH COURSE & MAJOR(if applicable)

COMPLETE ADDRESS

CONTACT NO.

RELIGION

PREVIOUS SCHOOL SCHOOL

ADDRESS OF PREVIOUS SCHOOL
NAME OF HIGH SCHOOL Year Graduated

GUARDIAN'S INFORMATION

GUARDIAN EVELYN SANTOS CRISPINO RELATIONSHIP

LEGAL GUARDIAN COMPLETE
ADDRESS
CONTACT NO. 1-124 CABRERA ROAD, SUCAD, APALIT, PAMPANGA

CODE SUBJECT DESCRIPTION UNIT SECTION

ETHNS6101 Euthenics 1 1 1IT

FILI6201 Kritikal na pagbasa,pagsulat 3 1IT

GE6100 Understanding the self 3 1IT

GE6106 Purposive Communication 3 1IT

GE6114 Math in Modern World 3 1IT

ITE6101 Computing Fundamentals 1 1ITL

ITE6101 Computing Fundamentals 2 1IT

ITE6102 Computer Programming 1 1 1ITL

 ITE6102 Computer Programming 1 2 1IT

MATH6100 Calculus 1 3 1IT

NSTP6101 NSTP 1 3 1IT

PHYED6101 Physical Fitness 2 1IT

TOTAL UNITS

I hereby certify that the above information is true and correct,

Payment Upon Enrollment

Amount OR No.
Guardian's/Student's Signature over printed name:

Checked by: _____Shinckinche T. Balboa Submitted Credentials

Registrar/ Date Good Moral Character

PSA Birth Certificate (3 Photocopy) Form-138

Enrollment Approved:
(For Freshmen)
Alquin S. Malonzo
Form-137 (For Freshmen)
7School Director/ Date
Transcript of Records (For Transferees) Honorable
Dismissal (For Transferees) ALS Certificate (For ALS
Graduates) Diploma (For ALS Graduates)
Certificate of Ratings (For ALS Graduates)

Student's Copy