* All indicated with (*) are mandatory or required fields.
Application Information
Campus Site* :
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LYCEUM OF THE PHILIPPINES - LAGUNA LPU - ST. CABRINI SCHOOL OF HEALTH SCIENCES, INC.
Campus Site
Classification:
« Select a campus to show available classifications. »
Select on what are you are applying for.
Program* :
« Choose a classification to view courses/strands »
Priority Course / Program of the applicant
Entry Classification* :
<Select>
Freshman Transferee
Mandatory field. Classify applicant as new, transferee, cross enrollee
Year of Enrollment* :
<Select>
Batch of the student (for assessment purposes only, not necessarily the batch when the student enrolled).
Term* :
« Select Term »
School term of enrollment.
Year Level* :
<Select>
Year level of the student.
Personal Data
Surname* :
Mandatory field.
First Name* :
Mandatory field.
Middle Name* :
Mandatory field.
Gender* :
Mandatory field.
Nationality* :
<Select Nationality>
African American Belgian-Filipino Canadian Chinese DUAL Fil-Angolian Fil-Chinese Fil-German Fil-Indian Filipino Filipino American Filipino Japanese Filipino Taiwanese Filipino-Canadian Filipino-Chinese FILIPINO-JAPANESE Filipino-Korean Filipino-Spanish FILIPINO-YEMEN French German Half African Indian Iranian Italian Japanese Jardahian Korean Kuwaiti Myanmar Nigerian Norwegian Pakistani Papua New Guinean Phillipine American SOUTH KOREAN Turkish Ugandan VIETNAMESE
Classify applicant's Nationality from available list.
Check if the applicant is foreigner.
Religion* :
<Select Religion>
4th Watcher Adventist AGLIPAY Agnostic Atheist Baptist Born Again BUDDHISM Catholic Christ follower CHRISTADELPHIAN Christian Church of Christ Church of God Conservative Baptist DFCCI EFB Episcopalian Catholic Evangelical EVANGELICAL CHRISTIAN Father SQOPCUZ FourSquare Fundamental Baptist Hinduism IGLESIA MISTICA FILIPINA Iglesia ng Dating Daan Iglesia Ni Cristo Islam JEHOVA'S WITNESSES Jerosalem Jesus Is Lord JMCIM KALK Kingdom of Jesus Christ LDS MCGI Methodist Mormons Muslim new religion non-evangilical Non-sectarian Pentecostal Pentecostal Trinitarian PMCC 4th Watch Protestant Rizalista Roman Catholic Sabbath Keeper Seventh Day Adventist Signh Sikhism The Church of Jesus Christ Torah's Observant True Buddhism UCCP UNIFICATION CHURCH Universal UPC Christian
Select religion from available list.
Date of Birth* :
1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
January February March April May June July August September October November December
Encode date of birth to display automatic computation of age (YYYY-MM-DD). Mandatory field.
Place of Birth* :
As per birth certificate. Mandatory field.
Address* :
Civil Status*:
<Select>
Single Married Divorced Legally Separated Widowed Mandatory field.
<Select Region>
BARMM CAR NCR REGION I REGION II REGION III REGION IV-A REGION IV-B REGION IX REGION V REGION VI REGION VII REGION VIII REGION X REGION XI REGION XII REGION XIII
Select Region
<Select Province>
Select Province
<Select Municipality/City>
Select Municipality and Encode ZIP/Postal Code
Number, Unit, Street Name, Building
Barangay, Barrio, Village, Subdivision, District
Home Phone No.* :
(Area Code) Phone No.
Mobile Phone No.* :
(Area Code) Mobile Phone No.
Email Address* :
Personal Email Address
Enter Verification Code* :
Once you entered your e-mail, click the Send Verification Code button. You'll receive a confirmation e-mail on your indox or spam folder. Copy and paste it on the place holder. You may resend another verification code after a minute.
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Guardian Information / Contact Information:
Home Address*
Guardian Phone No.* :
Guardian* :
In case of emergency. Mandatory field.
Relationship* :
Relationship with the contact person given.
Guardian Job* :
Guardian Job. Mandatory field.
In case of emergency
Same as Contact Information
Contact Person* :
In case of emergency. Mandatory field.
Address* :
Home address of contact person.
Phone No.* :
Telephone number of contact person.
Other Information:
Financial Source:
<Select Source>
Business Employed Online Selling Parents Income Remmitance International Retirement Income Self Employed
Identify applicant's source of financial support in college. Mandatory field.
Annual Family Income* :
<Select>
100,000 - 250,000 251,000 - 400,000 401,000 - 550,000 551,000 - 700,000 701,000 & above
Indicate average/estimated monthly income of household members.
General Average in High School:
Family Members / Relationship*
Stat
LAST NAME
FIRST NAME
MIDDLE NAME
RELATIONSHIP
OCCUPATION
Educational Background*
Stat
SCHOOL YEAR FROM
SCHOOL YEAR TO
EDUCATION TYPE
COURSE/PROGRAM/STRAND
NAME OF SCHOOL
Determine what action to take for this application.
