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Urs Application Form for Grade 11

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Urs Application Form for Grade 11 URS Admission Form for Senior High School TO BE FILLED OUT ONLY BY THE ADMISSION OFFICER AND/ OR AUTHORIZED PERSONNEL LEARNER’S REFERENCE NUMBER TO RECEIVE AND/ OR PROCESS APPPLICATION UNIVERSITY OF RIZAL SYSTEM Province of Rizal Testing Center: Website: http://www.urs.edu.ph 1 URS Angono 4 URS Cainta 7 URS Pililla 2 URS Antipolo 5 URS Cardona 8 URS Rodriguez URS APPLICATION FORM FOR GRADE 11 3 URS Binangonan 6 URS Morong 9 URS Tanay ______ Semester, SY _______ 10 URS Taytay Documents/ Requirements Submitted: TO THE STUDENT AND PARENTS: 2 Photos (2X2) Birth Certificate Testing Fee Form 138 Good Moral Carefully read the Instruction before filling out the application form. Print neatly all information required. Only accomplished application forms, (URS Grade 11) will be processed. O.R. Number Received by: 1. NAME OF STUDENT-APPLICANT. Print of type your full name in the following sequence. LAST NAME, FRIST NAME, MIDDLE NAME. Place one letter in each box. Leave one box between names. Last First Paste a recent 2”X2” photograph (taken within the last three Middle months) in this box 2. GENDER Male Female 3. RELIGION Please print your full name at the back of the photo 4. DATE OF BIRTH (Month/ Day/ Year) AGE CIVIL STATUS 5 PLACE OF BIRTH (City/ Town, Province) 6. CITIZENSHIP a. Filipino ( If born abroad please submit a photocopy of a valid Philippine Passport or a BOI Identification Certificate) b. Natural Born Filipino c. Foreign (Specify) d. Dual (Specify) 7. HIGH SCHOOL (Where you completed/ are completing Junior High School / Grade 10): High School Name Expected Month/ Year (Do not abbreviate) of Completion Address (City/ Town, Province) 8. URS CAMPUS APPLIED FOR Do not include the same campus twice. Write NONE on the blank if you do not have other choices of campus and course. URS CAMPUS INTENDED TRACK (See list of Academic/ Tech. Voc .Track) TRACK CODE 1st choice 1st choice 2nd choice 1st choice 2nd choice 2nd choice Choose from among the following (two choices allowed) 1. URS Antipolo 3. URS Cardona 5. URS Pililla 7. URS Rodriguez General 2. URS Binangonan 4. URS Morong 6. URS Tanay Average 9. How many times have you applied for URS Grade 11 Admission? ______ What URS campus(es)? ______________________________________ 9. 10. CHILD OF A URS FACULTY OR EMPLOYEE? Place an X in the appropriate box. No Yes Name of Parent Employed by URS Official Designation College/ Office where employed Telephone No. 11. PERMANENT ADDRESS 12. ARE YOU SELF-SUPPORTING? Number & Street No Yes If Yes, nature of work (put an X to appropriate work) Subd/ Village/ Brgy Food Chain Crew Gasoline Boy/ Girl City/ Town & Province Vendor Messenger Postal Code Household Construction Telephone Others (please specify) ________________________________ Email Address Facebook Account 13. SOCIO ECONOMIC Furnish all the required information on each family listed. Write DECEASED after name of deceased family members. Under the Column “Highest Educational Attainment”, indicate the educational level which the household member actually completed. (i.e. Grade II, Third Year High School, High School Graduate, Second Year College, BSE or Ph. D., Ed. D.) NAME CITIZENSHIP MARITAL HIGHEST PRESENT MONTHLY STATUS EDUCATIONAL OCCUPATION INCOME ATTAINMENT (In Phil. Pesos) Father Mother Legal Guardian THIS FORM IS FREE OF CHARGE AND MAY BE PHOTOCOPIED URS-AA-SS-ADM-F-2017-02 Rev. 00 Effectivity Date: August 15, 2017 (Grade 11— Track Code) CAMPUS TRACK TRACK CODE ACADEMIC TRACK General Academic Strand (GAS) A 1001 Humanities & Social Sciences (HumSS) A 1002 ANTIPOLO TECHNICAL, VOCATIONAL & LIVELIHOOD TRACK Home Economics Tour Guiding Services T 1011 Bread and Pastry T 1012 ACADEMIC TRACK Accountancy, Business & Management (ABM) A 2001 General Academic Strand (GAS) BINANGONAN Humanities & Social Sciences HumSS), A 2010 Accountancy, Business & Management (ABM) A 2011 TECHNICAL, VOCATIONAL & LIVELIHOOD TRACK Information and Communication Technology (ICT) T 2013 TECHNICAL, VOCATIONAL & LIVELIHOOD TRACK CARDONA Agri-Fishery Aqua-culture T 7001 ACADEMIC TRACK Humanities & Social Sciences (HumSS) A 3001 Science, Technology , Engineering & Mathematics (STEM) A 3002 General Academic Strand (GAS) Accountancy, Business & Management (ABM) A 3010 Humanities & Social Sciences (HumSS) A 3011 Science, Technology , Engineering & Mathematics (STEM) A 3012 MORONG TECHNICAL, VOCATIONAL & LIVELIHOOD TRACK Home Economics T 3013 Industrial Arts Automotive Services T 3021 Electronic Servicing T 3022 Electrical Installations and Maintenance T 3033 Information and Communication Technology (ICT) T 3014 ACADEMIC TRACK Accountancy, Business & Management (ABM) A 4001 PILILLA General Academic Strand (GAS) Accountancy, Business & Management (ABM) A 4010 Humanities & Social Sciences (HumSS) A 4011 ACADEMIC TRACK Humanities & Social Sciences (HumSS) A 5001 Accountancy, Business & Management (ABM) A 5002 Science, Technology , Engineering & Mathematics (STEM) A 5003 General Academic Strands (GAS) Accountancy, Business & Management (AMB) A 5010 Humanities & Social Sciences (HumSS) A 5011 TANAY Science, Technology , Engineering & Mathematics (STEM) A 5012 Sports A 5013 TECHNICAL, VOCATIONAL & LIVELIHOOD TRACK Agri-fishery Organic Agriculture T 5021 Horticulture T5022 Animal Production T 5023 Information and Communication Technology (ICT) T 5014 ACADEMIC TRACK Accountancy, Business & Management (ABM) A 6001 Science, Technology , Engineering & Mathematics (STEM) A 6002 RODRIGUEZ General Academic Strands (GAS) Accountancy, Business & Management (ABM) A 6010 Humanities & Social Sciences (HumSS) A 6011 .
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