TYPE all information and attach your photograph by clicking the "Click To Upload Photo" button.. Print & submit this form together with the other requirements to the DLSL COLLEGE Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/ REQUIREMENTS WILL BE PROCESSED.

Application is made as	Freshman Transferee Second Undergraduate Course Graduate Student Cross Enrollee Audit Student Others		Click To Upload Photo NOTE: Only JPEG(.jpg) files are allowed.
School Year
Semester	First Semester Second Semester
Last Name
First Name
Middle Name
Course of Choice
1st Choice		Certificate in
2nd Choice		Certificate in
3rd Choice		Certificate in
Personal Information
Date of birth		Gender	Male Female
Age		Religion	Roman Catholic Protestant Iglesia ni Kristo Adventist Others
E-mail address		Civil Status	Single Married
Place of birth		IF MARRIED
Contact Number		Name of Husband/Wife
Citizenship		Occupation
		Number of Children
Mailing Address
Street		Brgy./Subdivision
City/Town		Postal code
Province

	FATHER	MOTHER
Full Name
Citizenship
Home address
Tel.No./Mobile No.
E-mail address
Occupation
Employer
Business address
Tel. Number(s)
Educational Attainment
Last school attended

Is your father or mother an employee of DLSL?	None Father Mother Both
Check the classification of specified parent	Administrator Faculty Staff/Personnel
Is your father or mother an alumna of DLSL?	None Father Mother Both
Kindly indicate, Level/Degree:
Year Graduated
Guardian's Name (If not living with parents)
Guardian's Mailing Address
Guardian's Contact Number
Living arrangement:	Own house Boarding House Apartment Staying with relatives Others :

BROTHERS AND SISTERS

NAME	AGE	STATUS	SCHOOL	COURSE	LEVEL/YR GRAD
		Single Married
		Single Married
		Single Married
		Single Married
		Single Married
		Single Married
		Single Married
		Single Married

NAME	SCHOOL	YEAR ATTENDED	HONORS/AWARDS
GRADE SCHOOL
Nursery
Kinder
Prep
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
HIGH SCHOOL
Year I
Year II
Year III
Year IV
COLLEGE
SCHOOL/UNIVERSITY COURSE SEM/SY AWARDS Year I Year II Year III Year IV

Is this your first time to apply at DLSL?	Yes No
Date of previous application
Reasons for applying at DLSL
Hobbies and Special Talents (please separate each with a comma)
Membership in School / Outside Organization (please separate each with a comma)
Where did you first find out about De La Salle Lipa?	Career Orientation Posters Internet Family Friends Advertisements Other:
Do you have other source of financial suport for your education?	Yes No
If your answer is Yes, please specify :
Are you a working student?	Yes No
	If Yes please supply the following information below.
Job Title :
Job Description :
Company :
Business Address :
Telephone Number/s :
Are you in a good health condition?	Yes No
	If your answer is No, please specify:
Physical Disabilities / Defects
Do you have other sourse of financial suport for your education?	Yes No
	If your answer is Yes, please specify :
By clicking the Submit button, you are certifying that the information given herein is correct and complete. Falsification or withholding of information on this form will automatically nullify my application and/or subject me to dismissal from the college.
Click the Submit button to complete your application.

Online Student Application 2011

DLSL Admissions Office