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CHILD INFORMATION SHEET
for S.Y. 2023-2024
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* Indicates required question
Student Status
*
Choose
Old Student
New Student
Last Name
*
Your answer
First Name and Middle Initial
*
E.G. Juan Antonio B.
Your answer
Home Address
*
Your answer
Telephone Number
*
Your answer
Gender
*
Choose
Girl
Boy
Birthday
*
MM
/
DD
/
YYYY
Birthplace
*
Your answer
Grade/Level Applied
*
Choose
Junior CASA
Senior CASA
Advance CASA
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Junior Class
Senior Class
Special Education
Age as of June
*
Your answer
Current School
Your answer
Date Attended
MM
/
DD
/
YYYY
Referred by:
If you have been referred by an LPMS parent, please type their name.
Your answer
Enrollee's Religion
Your answer
Mother Tongue
The language first learned by a learner.
Your answer
Is the child vaccinated for COVID 19?
*
Yes
No
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