LEONARD | Registration Form

Learner Pre-Registration Form

Personal Information

LRN *

First Name *

Middle Name

Last Name *

Suffix

Gender *

Civil Status

Date of Birth *

Place of Birth

Nationality

Mother Tongue

PWD

IP (Ethnic Group)

Religion

Skills

Hobbies

Contact Number

Email Address

Current Address

House No. & Sitio/Street

Province

Municipality/City

Barangay

Parents Information

Father

First Name

Middle Name

Last Name

Suffix

Occupation

Contact Number

Mother (Maiden Name)

First Name

Middle Name

Last Name

Occupation

Contact Number

Guardian Information

Assign Guardian

Father

Mother

Others

First Name

Middle Name

Last Name

Suffix

Occupation

Relationship

Contact Number

Email Address

Current Address

Same as Learner's Address

House No. & Sitio/Street

Province

Municipality/City

Barangay

Educational Background

Elementary School

GWA

Year Graduated

Junior High School

Year Graduated

Senior High School

Year Graduated

Learner Type

Year Level (Last Attended)

Track

Strand

Specialization

Semester

Scholarship/Financial Grant/Citation

Entry Credentials

Form 137

Form 138

Good Moral

PSA

I agree to the Data Privacy Statement.

In compliance with the Data Privacy Act of 2012 (RA 10173), the personal information you provide will be collected, processed, and stored solely for legitimate school purposes and handled with strict confidentiality.