(As stated in Birth Certificate. Please PRINT or TYPE.
)
STUDENT APPLICANT Surname
Center for Admissions
2544 Taft Avenue, Manila, Philippines 1004 Pacheco
Tel Nos: (+63) 2 8230-5100 1801 to 1803
First Name
Email: admissions@benilde.edu.ph
Website: www.benilde.edu.ph Jonah Hazel
Middle Name
Paulino
Nickname
Gender Male 5Female
Recommendation Form
School: Years Attended: to:
School
Address:Female
To the Applicant:
Write the information needed above. This form is to be accomplished by the counselor, homeroom adviser, or discipline
officer only. Afterwards, submit to the Center for Admissions. The Center reserves the right to render the answers to this
form invalid if the explanation for a substitute rater is unsatisfactory.
Verification/Authorization:
I knowingly and voluntarily consent to the disclosure and processing of my personal information and sensitive personal
information (general assessment, disciplinary records and special need, psycho-emotional condition, and physical
disability) contained in this form to De La Salle-College of Saint Benilde for purpose of assessing my college application.
This information will be shared with the members of the admissions committee. I waive my right to inspection and
correction of the contents of this recommendation form.
Pacheco, Jonah Hazel Paulino
Printed Name and Signature of Applicant Date Printed Name and Signature of Date
Parent/Guardian
To the Evaluator:
The above person is applying for admission to De La Salle-College of Saint Benilde. Please give your assessment of the
applicant carefully and fill out the form completely. After accomplishing this form, please return to the applicant with your
signature. Unsigned recommendation form will not be accepted. Thank you very much for your assistance.
A. General Assessment: How would you assess the applicant using the following criteria?
Above Average Average Below Average No Change to Oberve
Problem Solving
Creativity
Analytical Thinking
Collaboration/Teamwork
Oral Communication
Written Communication
Leadership
Motivation to study
B. General Description. Did the applicant declare or manifest any special learning needs, psychological-emotional
conditions, or physical disability while enrolled in your school? If yes, please specify.
C. Discipline/Behavior Description. Has the applicant been involved in any minor (less serious) or (serious) - disciplinary
cases/offenses? What is the nature of the offense?
What is the corresponding responsibility/formative intervention and/or penalty that was implemented by your school?
D. Summary Evaluation. Considering the applicant¶s character and attitude, your overall recommendation is:
Strongly Recommended Recommended Recommended With Reservation Not
Recommended
Explanation and/or comments: (Use extra sheet/s if necessary)
Tel./Contact Nos.
Email:
Date Accomplished
Printed Name and Signature of Evaluator
Length of time acquainted with the applicant
Position (Pls. tick one)
Counselor Homeroom Adviser Discipline Officer AdC-RFC
S. 2024-1
