Form VCA 1
V E L E Z C O L L E G E, I N C Please attach one
2X2 colored ID
. picture with white
Cebu City, Philippines background
GUIDANCE OFFICE
Tel No.: (032) 253-2018
APPLICATION FOR NEW STUDENT
Thank you for your interest in Velez College. If you have any questions in completing this application,
please call (032) 253-2018 or email us at admission.at.velez@gmail.com. Please fill out the form legibly.
I. PERSONAL INFORMATION
NAME OF APPLICANT (Surname) (First Name) (Middle Name)
in CAPITAL letters:
Date of Birth: (mm/dd/yyyy) Place of Birth: Male Female
Present Address: Zip Code:
Permanent Address (if different from present address): Zip Code:
(Landline) (Mobile Phone) Email Address:
Contact Number:
Religion From Birth: Current Religion:
Dialects/Languages spoken at home: Dialects/ Languages Most Fluent in: Citizenship:
II. FAMILY BACKGROUND
Fathers Name: Occupation:
Mothers Name: Occupation:
Parents Landline: Mothers Mobile Phone #:
Parents Email Address: Fathers Mobile Phone #:
III. EDUCATIONAL BACKGROUND
Grade/Year Level Name of School Address Inclusive Dates Honors Received
Completed
Elementary
High School
IV. CONTACT IN CASE OF EMERGENCY
Name of Person:
Relationship: Phone No. (Home) Mobile Phone #:
Address: Zip Code:
I hereby certify that all entries herein are true and correct.
Date of Submission: ______________________ Students Signature: _____________________
Office of Student Services and Affairs: (032) 253- 2018 Email: admission.at.velez@gmail.com