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    04091202012

    Uploaded by

    Kate Angela

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    © All Rights Reserved
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    04091202012

    Uploaded by

    Kate Angela
    4 views1 page

    Copyright

    © © All Rights Reserved

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    Copyright:

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    4 views1 page

    04091202012

    Uploaded by

    Kate Angela

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    © All Rights Reserved
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    CABUYAO INSTITUTE OF TECHNOLOGY

    SENIOR HIGH APPLICATION FORM


    REFERENCE NUMBER: 04091202012

    CITECH-OL FORM-1
    NAME: Villaflor, Kate Angela Alcedo
    LRN: 424502150349 WITH VOUCHER? YES
    DATE OF BIRTH: NOVEMBER 30, 2003 PLACE OF BIRTH: Quezon Province
    PRESENT ADDRESS: Blk 132 Lt23 Ph2 Mabuhay City, Mamatid, Cabuyao, Laguna
    CITIZENSHIP: Filipino RELIGION: Roman Catholic SEX: FEMALE

    ARE YOU A REGISTERED VOTER OF CABUYAO CITY?: NO WHERE?: SINCE?:


    MOBILE NO.: 09081789283 TELEPHONE NO.:
    EMAIL ADDRESS: villaflorkateangela@gmail.com
    LAST SCHOOL ATTENDED.: Infant Jesus Montessori Center
    JUNIOR HIGH SCHOOL: Infant Jesus Montessori Center YEAR GRADUATED: 2021 HONORS RECEIVED:
    ELEMENTARY: Infant Jesus Montessori Center YEAR GRADUATED: 2017 HONORS RECEIVED:
    CIVIL STATUS: Single SPOUSE NAME: SPOUSE LEGAL ADDRESS:
    FATHER'S NAME: HIGHEST EDUCATIONAL ATTAINMENT: AGE: 50
    CONTACT #: OCCUPATION: MONTHY INCOME:
    COMPANY: COMPANY ADDRESS:
    MOTHER'S NAME: Elena A. Alcedo HIGHEST EDUCATIONAL ATTAINMENT: College AGE: 50
    CONTACT #: 09995575536 OCCUPATION: Business Woman MONTHY INCOME: 20000
    COMPANY: COMPANY ADDRESS:
    ARE YOUR PARENTS REGISTERED VOTERS OF NUMBER OF CHILDREN IN THE BIRTH
    CABUYAO CITY?: YES FAMILY: 3 ORDER: 3rd
    FIRST CHOICE: ABM SECOND CHOICE: STEM-ENGINEERING
    (1ST) WHOSE CHOICE: OWN CHOICE (2ND) WHOSE CHOICE: PARENT'S CHOICE

    CODE STRAND
    EXAM
    STEM-ENGINEERING Science, Technology, Engineering, and Mathematics (Specialization:
    Engineering)

    STEM-COMPUTING Science, Technology, Engineering, and Mathematics (Specialization:


    CS/IT)
    G.A

    HUMSS Humanities and Social Science

    ABM Accountancy, Business and Management


    F.A.G

    TVL Technical-Vocational Livelihood

    I certify that the information I have given above and the credentials I have submitted are true, correct, and complete to the best
    of my knowledge.

    ATTESTED:

    ________________________________________________________ ______________________________________
    (SIGNATURE OF PARENT/GUARDIAN OVER PRINTED NAME) (SIGNATURE OF APPLICANT)

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