Loyola Student Center

Main Office ê Unit 202 Loyola Serviced Residences, 88 E. Abada St., Loyola Heights, Q.C. Batch
' 8 929-9283 or 8 434-1916 or 8 533-5814 or 09228933820

Ortigas ê Unit 828 Mega Plaza Condiminium, Ortigas Center, Pasig City ' 8 687-4608 Review
Cainta ê Lot 10 & 11 Ponce St., Phase 7, Vista Verde Executive Village, Cainta ' 8 682-9391 CETR ACET only
SrHSR ASHAPE only
NMAT PhiLSAT/LAE
ONLINE REVIEW REGISTRATION FORM HSET/SHSR

Complete Name

Last First Middle Nickname

Complete mailing address

No. Street Barangay/Subdivision Municipality/City/Province Zip Code

Student Contact Number/s Student E-mail Address

School

Name Address
Person to notify in case of emergency

Name Relation Contact Number(s) E-mail Address

Please put x in appropriate boxes.

A. For which school/s do you intend to take the entrance test?
Ateneo de Manila University BEREA Arts & Science School
De La Salle University Philippine Science High School
University of Asia and the Pacific Quezon City Science High School
University of Sto. Tomas others, please specify _________________________
University of the Philippines
B. You learned about LSC through:
friends LSC signage streamer poster flyer
relatives school
newspaper ads others, please specify _________________________

I certify that the above information is true and correct, and I have read
Date of Registration and understood the policies of the review.

Relation (if representative) Signature of Student / Representative over Printed Name

To be filled out by the Center:

Fee __________________ Payment Made ____________ Receipt No.: _________________ Date __________
Balance (if any) ___________ Due Date: __________________ Received by: _____________________
Remarks: ___________________________________________________________________________________________