STUDENT APPLICATION FORM A

THE BEACON ACADEMY

APPLICATION FORM A
To be completed by parent/guardian

Please provide any information that could help us better understand and support your child.
STUDENT APPLICANT INFORMATION
Please upload your child's most recent 2x2 photo*
Learner Reference Number (LRN):*
This is a number assigned to each learner by the Philippine Department of Education. Please ask your School Registrar for your LRN. For students coming from international schools or schools abroad, write NA if not applicable.
Applying for Grade:*

Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12
School year:*
eg: 2020-2021
Applicant's Name (your child's name as it appears in the birth certificate):*

First NameMiddle Name (put NA if not applicable)Last NameSuffix
Your child's preferred name:*
Gender:*

MaleFemale
Date of Birth:*

MonthDayYear
MM/DD/YYYY
Age:*
Place of Birth:*

PhilippinesOther Country
Other Country: Please specify place of birth:*
eg: USA, Japan
Visa Status:*
Tourists, Balikbayan, and short-term visitors will be asked to secure for a Special Study Permit upon enrollment.
Nationality:*
Citizenship/s:*
Please specify single citizenship:*
Please specify dual citizenship:*
Current Date*

MonthDayYear
Date
Other visa types, please specify:
Religious Affiliation:*
First Language:*
Other Languages Spoken at Home:*
Write NA if not applicable
HOME ADDRESS
Home Number and Street:*
Home number, Street
Barangay or Village:*
Barangay or Village
City and State / Province / Region (ie: Binan, Laguna)*
City and State / Province / Region
Zip Code
Home number, Street, Barangay or Village, City, Country, ZIP code
Mailing Address (if different from above):
Home number, Street, Barangay or Village, City, Country, ZIP code
Home Telephone (add if any):
Please enter a valid phone number.
CONTACT DETAILS
Child's mobile number:*
Please enter a valid mobile number
Child's email address:*
example@example.com
CURRENT SCHOOL
Name of current school*
CURRENT SCHOOL INFORMATION:*

LIST OF SCHOOLS ATTENDED (including current school):*

	Name of School	Address (city, country)	Dates Attended (month-year to month-year) ex: August 2000-May 2004	Grade Level	Language of Instruction
1
2
3
4
5
6

Reason/s for Transferring to Beacon Academy:*
Additional Information
To ensure we can provide the best possible learning experience for your child, we would greatly appreciate your detailed responses to the following questions:

	Name of Siblings	Date of Birth	Age	Schools Attending / Attended	Current Level
1
2
3
4
5
6

THE BEACON ACADEMY

To be completed by parent/guardian

STUDENT APPLICANT INFORMATION

Additional Information

ACADEMIC PROFILE

INTERPERSONAL

INTERESTS AND PERSONALITY

Additional Information

FAMILY INFORMATION

FATHER'S INFORMATION

MOTHER'S INFORMATION

LEGAL GUARDIAN INFORMATION

Emergency Contact Information (aside from above)

ADDITIONAL INFORMATION