JHS Admission

For Incoming Grade 7 and Transeferee, Please call the Registrar’s Office @ 415-9157

Student Classification*
School Year*
Grade Level To Enroll*
School Last Attended (For Transferee/New Student ONLY)
School Last Attended Address
Street Address City State / Province / Region ZIP / Postal Code Country
Student's Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Place of Birth*
Age*
Please enter a number from 1 to 100.
Sex*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Contact Number*
Students Email*
Father's Name
First Middle Last
Highest Educational Attainment
Hidden
Others Please Specify
Employment Status
Working from home due to community quarantine?
- YES
- NO
Mother's Maiden Name
First Middle Last
Highest Educational Attainment
Hidden
Others Please Specify
Employment Status
Working from home due to community quarantine?
- YES
- NO
Guardian's Name
First Middle Last
Highest Educational Attainment
Hidden
Others Please Specify
Employment Status
Working from home due to community quarantine?
- YES
- NO
Is your family a beneficiary of 4Ps?*
- YES
- NO
How does your child go to school? Choose all that applies.*
- Select All
- Walking
- Public commute (land/water)
- Family-owned vehicle
- School Service
Do you have a household member who is studying in Diaz College for SY: 2020-2021?*
- YES
- NO
Who among the household members can provide instructional support to the child's distance learning? Choose all that applies.*
- Select All
- Parents/Guardians
- Elder Siblings
- Grandparents
- Extended members of the family
- Others (tutor, house helper)
- None
- Able to do independent learning
What devices are available at home that the learner can use for learning? Check all that applies*
- Select All
- Cable TV
- Non-cable TV
- Basic Cellphone
- Smartphone
- Tablet
- Radio
- Desktop Computer
- Laptop
- None
Do you have a way to connect to the Internet?*
- YES
- NO
How do you connect to the Internet? Choose all that applies.*
- Select All
- Own Mobile Data
- Own Broadband Internet (DSL, Wireless Fiber, Satellite)
- Computer Shop
- Other Places outside the home with internet connection (library, barangay/municipal hall, neighbor, relatives)
- None
What distance learning modality/ies do you prefer for your child? Choose all that applies.*
- Select All
- Online Learning
- Television
- Radio
- Modular Learning
- Combination of Face to Face with other Modalities
What are the challenges that may affect your child's learning process through distance education? Choose all that applies.*
- Select All
- Lack of available gadgets/equipment
- Insufficient load/ data allowance
- Unstable mobile/internet connection
- Existing health condition/s
- Difficulty in independent learning
- Conflict with other activities (i.e. house chores)
- No or lack of available space for studying distractions (i.e. social media, noise from community/neighbor)
Please choose Mode of Payment:*
- Full Payment
- Monthly Installment
Upload 1×1 Picture
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FORM-138 (CARD)
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Certificate of Good Moral Character
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PSA Birth Certificate
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JHS Admission

Contact Us

(035)523-3453

(035)531-6688

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