Admission Form

1 Student Information

Last Name

First Name

Middle Name

Place of Birth

Date of Birth

Gender

Home Address

Last School Attended

Year

Previous Principal's Name

Principal's Contact #

Student's Photo

JPG or PNG, up to 3 MB.

2 Parent / Guardian

Father's Name

Father's Contact #

Father's Place of Work

Mother's Name

Mother's Contact #

Mother's Place of Work

Guardian's Name (if any)

Guardian's Contact #

Emergency Contact Person

Emergency Contact #

Authorized Pickup Person's Phone

Email Address (optional)

Photo of Parent/Authorized Pickup Person

JPG or PNG, up to 3 MB.

3 Child Medical History

This section is kept strictly confidential and is only ever visible to school staff.

4 Grade / Division Applying For

5 Parent / Guardian Commitment

I promise to work with my child at home with his/her lessons and homework for at least:

Are you willing to inform the institution of your child's learning weaknesses?

Yes No

Is your child faced with a psychological effect in their learning ability?

Yes No

I promise to attend all PTA meetings (failure to attend means I agree to pay the school's PTA fine), and failure on my part to help my child with lessons shows I agree for the institution to take appropriate academic action. I will be available when called upon by the school administration. Signing this form shows I agree to what is stated here.

Parent/Guardian Signature (type your full name)

6 Student's Behavior Bond

I, the student named above, do hereby promise to abide by all rules and regulations stipulated in the Margaret Peggy Good Memorial Christian Academy (MPGMCA), Inc. Student's Handbook, to demonstrate respect, obedience, and good moral conduct to all faculty, staff, and fellow students, on and off campus. Failure to adhere to these rules may result in disciplinary action including suspension or expulsion.

Student Acknowledgement (type student's name)

Parent/Guardian Name

Relationship to Student

Parent/Guardian Acknowledgement (type your full name)

Parent's Contact Number

7 Supporting Document (optional)

Birth certificate, Road to Health card, transcript, or similar

JPG, PNG, or PDF, up to 5 MB.