INSTRUCTIONS:
1. Please complete the form below.
2. Click on the "Verification" check box and click on "Proceed" button.
3. Download the form in a PDF Format.
4. Attach the signature of the applicant and the parent or guardian.
5. Email accomplished form to liceoadmission@usls.edu.ph
Note: Cut off Average for STEM Strand in (English, Science & Mathematics) is 80.

NOTE: Please fill up the form using UPPERCASE letters.


Academic Year: 2021-22
Semester:
*Applicant Type:
*Strand
*Year Level


*Course you want to pursue for College:
*Have you been admitted in USLS before (From IS)?


DIRECTIONS: Please fill-out the form truthfully, completely and clearly. If some of the items do not apply, please type None. This will be your official record.
PERSONAL DATA
Picture Limit Image size is 70kb Only | .jpg Format
*Name
*Address
*Contact
*Birthdate
*Sex
*Religion
*Civil Status
*Citizenship
*Weight (kg)
*Height (in)


Do you have any physical/mental conditions that may affect your performance in School?

EDUCATIONAL BACKGROUND
If some of the items do not apply, please type None. This will be your official record.
*Learner Reference Number [LRN]: *check with your school registrar
*Elementary
If not in the list, please encode the correct/exact name of the school and address below
*Address
*Year Started
*Year Graduated
*Junior High School
If not in the list, please encode the correct/exact name of the school and address below
*Address
*Year Started
*Year Graduated
*Type of School
Academic Achievement
Special Awards
Are you a recipient of a Scholarship Program?
Do you want to apply for a scholarship program?
Are you an ESC/FAPE/GASTPE Grantee?




FAMILY BACKGROUND
If some of the items do not apply, please type None. This will be your official record.
Father's Information
*First Name
*Middle Name
*Last Name
Citizenship
Civil Status
Mailing Address
*Contact No.
Employment
Monthly Income
Mother's Information
* First Name
*Maiden Middle Name
*Maiden Last Name
Citizenship
Civil Status
Mailing Address
*Contact No.
Employment
Monthly Income


Person/Guardian to Contact in Case of Emergency
*Name *Address *Relation *Contact No. Email

Password Creation

This will be used for your online account (Viewing of Grades/Schedule/TBI/E-Clearance). The password should be a minimum of eight(8) characters in length.

*New Password: *Re-type Password:


VERIFICATION

I certify that the information written in this application is complete and accurate. Any falsification of any information on this form will automatically nullify my application and/or subject me to dismissal from the university.
I am willing to accept the Mission Statement of this Catholic University and the objectives of Liceo-De La Salle Senior High School and to abide all the rules and regulations of the University of St. La Salle.

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