Student Personal Information Sheet

FIRST SEMESTER 2025-2026

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Academic Information

Status *

Department

Program/Course *

Major

Year Level

Term

Instructions: Fill out all the required information needed. Leave it blank if not applicable.

UPLOAD PHOTO

UPLOAD PHOTO

Please select a VISA-PASSPORT size photo.

[.jpg, .png files only]

Personal Information

*ID Number

*Religion

*Civil Status

*Contact No

*Email Address * You will receive your login credentials at this email

Father's Name

*Lastname

*Firstname (eg.JOHN SR.)

Middle Name

Mother's Name

*Lastname

*Firstname

*Middle Name

Maiden Middle Name

Student Details

First Name *

Middle Name

Last Name *

Date of Birth *

Gender

Home Address: [AUTO]

Street/Purok/Barangay *

City/Town *

Province *

Zip Code

Copy Home Address to Current Address

Current Address: [AUTO]

Street/Purok/Barangay

City/Town

Province

Zip Code

Contact & Guardian Information

*Parents Contact No.

*Name of Guardian/Landlady/Landlord

*Guardian Contact No.

Household & Financial Information

DSWD Household No (If Available)

Monthly Income

Disability (if any)

Organization(s) Affiliated (Leave blank if not applicable)

CITIZENSHIP

Select your citizenship

*Have you been disciplined for any infraction or violation of school rules and regulations?

Yes, specify
No

Pledges & Consents

*Do you promise not to take any prohibited drugs as long as you are connected with this university?

*Do you promise not to participate in any unlawful act or any illegal assembly?

*I allow this university to use my personal information, photos, videos and audio recordings for marketing and promotion of the university

*I confirm my consent to this university for the processing of personal information data relating to me for university administration, student and graduate studies and management purposes by choosing this option.

Did someone from this university assist you during your pre-registration?

STUDENT'S PLEDGE

I promise to faithfully perform my duties and responsibilities as a student in this University and abide by its policies, rules and regulations and certify that all statements and information are true and correct.

*Attested/Witness by

*Relationship

Additional Notes