College Application for Enrollment

Option 1

Clear selection

Date of Enrollment: *

MM

/

DD

/

YYYY

Last Name: *

Given Name: *

Middle Name:

Suffix: (Jr., Jra., Snr., etc...)

Student's Status: *

Old Student

New Student

Transferee

Returnee

Shifter

If Shifter, please indicate the last course attended:

Student ID No.: ((for old student only)

Sex: *

Male

Female

Civil Status: *

Citizenship: *

Religion: *

Age: *

Date of Birth: *

MM

/

DD

/

YYYY

Place of Birth: *

Current Address (Ex. Renting,Hotel,etc.): *

Permanent/Home Address

House Number and Street: *

Subdivision/ Barangay: *

City/Municipality: *

Province: *

Country: *

Tel. No./Cell No.: *

Email Address: *

Social Media Account: *

Messenger

Viber

Line

Other

Required

If other, specify what social media account:

Specify Social Media Name: *

Father: *

Occupation: *

Mother: *

Occupation: *

Tel. No./ Cell No. of Parent/Guardian: *

Email Address of Parent/Guardian: *

In case of Emergency who will be notified?

Name: *

Address: *

Tel. No./Cell. No. of Person to notify: *

School Year Last Attended (for new student and returnees):

Name of School Last Attended (for new student and returnees):

Address of School Last Attended (for new student and returnees):

Semester: *

1st

2nd

Summer

Required

Program/Course: *

Bachelor of Science in Information Technology

Bachelor of Science in Marine Transportation

Bachelor of Science in Marine Engineering

Bachelor of Science in Business Administration

Bachelor of Science in Nursing

Bachelor of Elementary Education

Bachelor of Science in Hotel and Restaurant Management

Bachelor of Science in Criminology

Bachelor of Science in Civil Engineering

Bachelor of Science in Electrical Engineering

Bachelor of Science in Mechanical Engineering

Bachelor of Secondary Education Major in Mathematics

Year Level: *

1st

2nd

3rd

4th

5th

Admission Credentials Submitted (for new student only)

Form 137

Form 138

T.O.R.

NSAT

Cross-Enroll Permit

PSA/NSO Birth Certificate

Good Moral

Prospectus guide,please click link below. (New Curriculum for 1st to 3rd Year; Old Curriculum for 4th to 5th year)

Subject to Enroll (Subject Code, Descriptive Title, Units) *

Subject to Enroll (Subject Code, Descriptive Title, Units)

Total Units: *

Available Resources: *

Internet

Mobile Data

Laptop/Tablet/Smart Phone

Internet Cafe

Television

Radio

None of the above

Required

Preferred Type of Class: *

Online

Face to Face (not applicable due to government restriction)

Modular

Blended

Do you want to avail Pre-paid Home Wifi (to be added to your school fees)? *

Yes

No

Confirmation

You are officially enrolled upon payment of P1,000.00 enrollment fee payable at the cashier or through online payments options. A piece of advice, just wait for our message or confirmation before you pay for the enrollment fee.
Thank you for trusting SCSIT. We will inform you soon for your schedule and more updates. For your questions and clarifications please try to contact Registrar's Office, 261 - 0234, and 0917. 702.7937.We will email you to confirm your enrollment and request further documents if needed.

I hereby agree and understood the enrollment form. I also allow SCSIT to collect and keep my personal information which may be used for school purposes only. *

Agree

Disagree