CLIP ONE Application No.
ID PHOTO HERE
(1 X 1)
PLS DO NOT USE
GLUE / TAPE / PASTE
PERSONAL INFORMATION SHEET
(PLEASE PRINT LEGIBLY)
LEGAL NAME
(Name on Birth Certificate) LAST NAME GIVEN NAME MIDDLE (Give Full Middle Name)
CURRENT SCHOOL
HOME ADDRESS
ZIP CODE
TEL / MOBILE # CITIZENSHIP RELIGION
DATE OF BIRTH PLACE OF BIRTH
FATHER’S NAME Living ( ) Deceased ( )
RELIGION CITIZENSHIP DATE OF BIRTH
HOME PHONE # MOBILE # E-MAIL ADDRESS
Would you like to receive notifications via email? [ ] YES [ ] NO
OCCUPATION EMPLOYER & ADDRESS TEL/FAX
MOTHER’S NAME Living ( ) Deceased ( )
RELIGION CITIZENSHIP DATE OF BIRTH
HOME PHONE # MOBILE # E-MAIL ADDRESS
Would you like to receive notifications via email? [ ] YES [ ] NO
OCCUPATION EMPLOYER & ADDRESS TEL/FAX
PARENTS ARE ( ) Together ( ) Separated ( ) Widowed ( ) Not Married ( ) Marriage
Annulled SON LIVING WITH ( ) Both Parents ( ) Father ( ) Mother ( ) Guardian
GUARDIAN’S NAME (if any) Relation to Applicant
HOME PHONE # MOBILE # E-MAIL ADDRESS
Would you like to receive notifications via email? [ ] YES [ ] NO
HOME ADDRESS
OCCUPATION EMPLOYER & ADDRESS TEL/FAX
NAMES OF BROTHERS / SISTERS AGE SCHOOL / OCCUPATION
OF APPLICANT
Personal Information Sheet
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Application No.
Ateneo Junior High School
APPLICATION FOR ADMISSION Application for
IMPORTANT: Applicants may take the entrance test for Grade 8 only once. Grade 8
PERSONAL INFORMATION
LEGAL NAME _
(Name on Birth Certificate) LAST NAME GIVEN NAME MIDDLE (Give Full Middle Name)
HOME ADDRESS
ZIP CODE TEL. NO. MOBILE NO. EMAIL
Would you prefer to receive notification via this email address? [ ] YES [ ] NO
DATE & PLACE OF BIRTH CITIZENSHIP RELIGION
FATHER’S NAME [ ] LIVING [ ] DECEASED
CITIZENSHIP RELIGION OCCUPATION
MOTHER’S NAME [ ] LIVING [ ] DECEASED
CITIZENSHIP RELIGION OCCUPATION
GUARDIAN’S NAME (If applicable)
ADDRESS
RELATION TO APPLICANT OCCUPATION
TELEPHONE # CELLPHONE # EMAIL
SCHOLASTIC BACKGROUND
List all schools you attended beginning from the lowest grade.
ELEMENTARY SCHOOL LOCATION GRADE(S)
Grade to Grade SY to SY
Grade to Grade SY to SY
Grade to Grade SY to SY
HIGH SCHOOL LOCATION YEAR(S)
Year to Year SY to SY
Have you ever applied to the Ateneo de Manila Junior High School prior to this application? YES NO
If YES, when? for what grade level?
Application for Admission Form
Page 1 of 3
List your extra-curricular activities, List any honors or prizes you have List your community or church
including positions held received for scholastic achievement activities
Were you ever dismissed from any school or denied re-admission? YES NO. If YES, provide name of school, school
year and reason(s).
Did you ever repeat a grade level? _ YES NO. If YES, provide name of school, school year and reason(s).
Were you ever placed on probation status? YES NO. If YES, provide name of school, school year and reason(s).
Did you encounter academic difficulties in the past? YES NO. If YES, please describe.
Were you ever diagnosed with conditions that prevented you from performing well in school, e.g. ADHD?
YES NO. If YES, please describe.
Name of Head or your present school
School Address
Tel. No.
HEALTH AND PHYSICAL FITNESS
Date of your last physical exam
Name of physician
List any health problems/medical conditions which should be taken into consideration in planning your school activities.
Application for Admission Form
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Have you ever been forced to stop schooling for a month or more because of poor health? YES NO.
If YES, provide details and dates.
AUTOBIOGRAPHY
Please write a brief handwritten autobiography touching on the following points: your chief interests, ambitions,
accomplishments, and your desire to pursue your education at the Ateneo de Manila. This is an important part of your
application and a good opportunity to make yourself known to the committee that will process applications for Grade 7.
Take time to think about what you will write and give attention to the fundamentals of good writing (content, organization,
and mechanics such as grammar and spelling). Make sure not to simply repeat information already provided in other pages
of this form. Limit your autobiography to one side of one (1) sheet of size A4 bond paper.
FINANCIAL AID
Are you applying for Financial Aid from the Ateneo? YES NO. If YES, secure a copy of the Financial Aid form from
the Ateneo Junior High School Administration Office. The form is also downloadable from
http://www.ateneo.edu/downloads/ateneo-junior-high-school-student-applications-information-requirements .
Fill up the questionnaire and provide a complete set of required documents before submitting the same to the Ateneo
Junior High School Admistration Office together with this application form. Financial Aid Forms with incomplete
requirements will not be processed.
RECOMMENDATIONS
Give the names and addresses of the persons who can send your Letters of Recommendation if requested by the
Admissions Committee. Choose two (2) persons who know you well and who have held positions of authority over you in
your present school (ex. teacher, counselor or principal). Do not include relatives or friends.
Name Position Address
CERTIFICATION
I hereby certify that all information supplied in this application is accurate and complete, and I authorize Ateneo de Manila
Junior High School to verify all information supplied herein. I further certify that I have not applied for the same grade
level at the Ateneo de Manila prior to this application. I fully understand that misrepresentation of information
supplied herein will be considered sufficient reason both for refusal of admission and exclusion.
Father’s/Guardian’s Signature Applicant’s Signature
Mother’s/Guardian’s Signature Date
--------------------------------------------DO NOT WRITE BELOW THIS LINE-----------------------------------------
Date Application Received
Action of the Admissions Committee:
[ ] ACCEPTED [ ] P1 [ ] P2 [ ] WAIT-LISTED [ ] REJECTED [ ]
Date of Decision Date of Notification
NOTES/COMMENTS
Application for Admission Form
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