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Senior High School: Ateneo de Zamboanga University
Senior High School: Ateneo de Zamboanga University
PERSONAL INFORMATION
Family Name Given Name Middle Name
Yamongan Jian Ashley Tarozza
Sex Grade, Strand & Section Date of Birth Place of Birth Are you an International student?
☒ No ☐ Yes
☒ Male
G11 STEM- Cornelius 04/14/05 Manila If YES, from where?
☐ Female
enter text
Zamboanga City Address: Contact person in case of emergency:
Tumaga Filinvest Block 14 Lot 55 Z.C.
enter address Name: Aleli T. Yamongan
Email Address: Jianyams14@gmail.com Tel. No. 9572583
Mobile No.: 09673655248 Relation: Mother
FAMILY BACKGROUND
Still living?
Name of Parents Religion Occupation Age Family Structure
(yes/no)
Roman
1. Aleli T. Yamongan Nurse 48 Yes ☒ Two-Parent ☐ Extended
Catholic
Roman
2. Wilmer T. Yamongan Seaman age Yes ☐ Others: specify
Catholic
Parents
☒ Living together
☐ Separated ☐ Widowed
Please list down the names and ages of your siblings from eldest to youngest including yourself.
Name Age Occupation Company/School
WCC aeronautical and
1. Johnred Angelo T. Yamongan 18 Student
technological college
2. Jian Ashley T. Yamongan 16 Student Ateneo de Zamboanga University
3. Jevon Andrei T. Yamongan 15 Student Ateneo de Zamboanga University
4. enter name age enter text enter text
5. enter name age enter text enter text
6. enter name age enter text enter text
Why have you decided to go to Senior High? (Check as many as you think are true) Financial Support in SHS:
☐To get a liberal education ☐ For social enjoyment ☐ Entirely supported by family
☐To prepare for a vocation ☐ I don’t know why ☐ Scholarship: Type of scholarship
☒To prepare myself for a college degree ☐ To please my parents & / or relatives ☐ Others: please specify
☐To get a job ☐ Others. Please specify please specify
☐To be with old school friends please specify please specify
☐To make friends and helpful connections
Main reason for selecting Occupational Preferences: (in the future) Reasons
Ateneo de Zamboanga University 1. enter text enter text
2. enter text enter text
Quality education
3. enter text enter text
I certify that the information I write on this form is true and correct.
By affixing my signature on this form, I also authorize the SHS GCO to share my health information with the ADZU Infirmary as pertinent
to my treatment.
Records maintained by the ADZU SHS Guidance and Counseling Office are considered confidential and protected information. This means
that what you write in this form or otherwise share with your counselor and the SHS GCO staff will remain confidential. Consultations with
individuals or organizations outside the SHS GCO, including faculty, family, or friends require your written consent. There are, however,
some exceptions and limitations to confidentiality as required by ethical responsibility and by law. Please speak with your counselor or any
SHS GCO staff if you have any questions.
Jian Ashley T. Yamongan 10/14/2021
Student’s Signature over Printed Name Date