STUDENT APPLICATION FORM A

THE BEACON ACADEMY

APPLICATION FORM A
To be completed by parent/guardian
APPLICANT INFORMATION
Please upload applicant'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 schools abroad, write NA if not applicable.
Applying for Grade:*

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

First NameMiddle Name (put NA if not applicable)Last NameSuffix
Preferred Name:*
Gender:*

MaleFemale
Date of Birth:*

MonthDayYear
MM/DD/YYYY
Age:*
Place of Birth:*
Nationality:*
Citizenship/s:*
Please specify single citizenship:*
Please specify dual citizenship:*
Current Date*

MonthDayYear
Date
Visa Status:
Tourist visas and short term visitors are not acceptable for study purposes. However, you may apply for a Student Study Permit.
Other visa, please specify:
Religious Affiliation:*
First Language:*
Home Address (please include Barangay and 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.
Mobile Number of the applicant:
Please enter a valid mobile number.
Email address of the applicant:*
example@example.com
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

THE BEACON ACADEMY