APPLICATION FOR ADMISSION FOR SENIOR HIGH SCHOOL

GRADE 11 to 12

Admissions Office
Tel. no.: (02) 932-9178 Email Address: admission@feudiliman.edu.ph
Sampaguita Ave., Mapayapa Village, Diliman, Quezon City, 1107

Incoming Grade Level: [ ] Grade 11 [ ] Grade 12

School Year
: ______________________
[ ] FRESHMAN [ ] Transferee [ ] International Student

Application Requirements and Procedures:

1. Secure the FEU Diliman application form from the Admissions Office or the downloadable version att www.feudiliman.edu.ph.
2. Accomplish the form and submit the same together with two recent I.D. picture (2x2).
3. Pay the non-refundable application and testing fee of P250.00 at the Cashier, Room 2-C, Admin. Bldg.
Cashier Office hours are from 8:30AM to 4:30PM, Mondays to Fridays.
4. Present your Official Receipt to the Admissions Office to claim your Entrance Exam Permit.
5. Take the exam on your scheduled date and time. Present your Entrance Exam Permit and an official ID on the
date of examination.
After the examination, the applicant and the Parent/Guardian will be scheduled for an interview.
A slip which contain the date and time of interview will be given to the applicant.

Place
PHOTO HERE

Submit the following document prior to the interview:

Original Form 138 (Report Card)
Additional for International Students:
NSO copy of Birth Certificate
Special Student Permit
Certificate of Good Moral Character Passport (Original & Photocopy)
2 pcs. Recommendation Form
2 pcs. 2x2 Colored Picture
Only applications with complete requirements will be interviewed.

PERSONAL INFORMATION
Last Name

First Name

Middle Name

Address
City

Province

Zip Code

Telephone No.:

Mobile No.:

Birthdate: (MM/DD/YYYY)

Birthplace:

Age: upon application

Gender: [ ]Female [ ]Male

Nickname:
Email address:

Religion:
Height

Citizenship:
Weight

Type of Visa: (If foreigh student)

FAMILY BACKGROUND
Father's Name

[ ] Living

Contact nos.:
Place of Work: [ ] Local

Email Address:

Citizenship:

Mother's Name

[ ] Living
Email Address:

Place of Work: [ ] Local

[ ] Abroad

Designated Guardian:

[ ] Father

Occupation:
Religion:

Address:

[ ] Abroad

Contact nos.:

[ ] Deceased

[ ] Deceased

Citizenship:

Occupation:
Religion:

Address:

[ ] Mother [ ] Other: ______________________________

Signature:

Guardian's Name:

Relationship:

Guardian's Address:

Occupation:

Guardian's Tel. No.:

Guardian's Mobile No.:

Guardian's Email address:

Applicant's Birth Order: ______ Number of Sibling (s): ___________ Do you have Sibling (s) studying in FEU Diliman? [ ] YES [ ] NO
Name of Sibling (s)

Age

Educational Attainment

SCHOLASTIC BACKGROUND

List all schools you attended beginning from the lowest grade.
Grade School

Location

High School

Grade
Grade

to Grade

S.Y.:

Grade

to Grade

S.Y.:

Grade

to Grade

S.Y.:

Location

Years
Year

to Year

S.Y.

to S.Y.

Have you ever applied to FEU Diliman Kindergarten/Grade School/High School prior to this application? [ ] YES [ ] NO
If YES, when? __________________________________________ For what grade/year level? __________________________________________
How did you learn about FEU Diliman? Kindly check all those apply:
[ ] FEU Diliman Student
[ ] FEU Diliman Faculty/Employee

[ ] FEU Diliman Alumni

Referred by: __________________________________________

[ ] Career Talk

[ ] Website

[ ] Print Ads

[ ] Others: _________

RECOMMENDATION

Give the names and addresses of the persons who will send your Letters of Recommendation. Choose two (2) persons who know you well
and who have held positions of authority over you in your present school (ex. Teacher, counselor or principal). Do not includ e relatives or
friends.
Name

Position

Address

CERTIFICATION

I hereby certify that all information supplied in this application is accurate and complete. In lieu, I authorize FEU Diliman (FEU FERN
College) to verify all information given. I fully understand that misrepresentation of information supplied herein will be considered
reason for bothe for refusal of admission or exclusion.
Father's/Guardian's Name and Signature:

Date:

Mother's/Guardian's Name and Signature:

Date:

Applicant's Name and Signature:

Date:
Do not write below this line.
APPLICATION PROCESSING
Action Taken

Exam Score/Rating:
Date of Exam:

Admission Officer
[ ] Ok for Admission

[ ] Refer to the Directress

[ ] Not Eligible for Admission

Admission Requirements Submitted:

[ ] NSO copy of Birth Certificate

Signature:

Date:

[ ] Form 138 (Report Card)

[ ] Medical Certificate

Directress

[ ] Certificate of Good Moral Character

[ ] Ok for Admission Eligible to enrol in :

[ ] 2 pcs. Colored Picture

[ ] Recommending Probation

Additional for International Students

Signature:

[ ] Passport
[ ] Special Student Permit

[ ] Not Eligible for Admission

Date:

[ ] No Accomodation