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Declaration.pdf

The DLSU-D Declaration Form must be completed by a School Representative for applicants seeking admission to De La Salle University - Dasmariñas. The form requires confirmation of the applicant's current enrollment status and eligibility for Senior High School - Grade 11 for the academic year 2025-2026. The applicant, John Martin Caberto Viado, certifies that he has not previously enrolled in SHS-GRADE 11 and acknowledges the consequences of providing false information.

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46 views

Declaration.pdf

The DLSU-D Declaration Form must be completed by a School Representative for applicants seeking admission to De La Salle University - Dasmariñas. The form requires confirmation of the applicant's current enrollment status and eligibility for Senior High School - Grade 11 for the academic year 2025-2026. The applicant, John Martin Caberto Viado, certifies that he has not previously enrolled in SHS-GRADE 11 and acknowledges the consequences of providing false information.

Uploaded by

nicoleibard
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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DLSU-D DECLARATION FORM

INSTRUCTIONS:
This declaration form must be filled out by the applicant’s School Representative either of the following:
Class Adviser, Guidance Counselor, School Registrar, or School Principal
After completing the DLSU-D Declaration Form, the student applicant must upload the form to his /her
DLSU-D Admissions Portal.
________________________________________________________________________________

To the EVALUATOR:
The below–named person is applying for admission at De La Salle University - Dasmariñas.
Please check whichever applies to the student applicant:
He is presently enrolled in your school.

Yes

No What is the last Academic Year attended? ____________________

I certify that the applicant is eligible to apply for SENIOR HIGH SCHOOL – GRADE11 for AY
2025-2026

EVALUATOR’S INFORMATION
Name (Last, First, MI) Designation (Please select the appropriate
designation) Class Adviser / Guidance
Counselor / School Registrar / School
Principal
Signature and Date Email Address / School’s Contact No.

******************************************************************************

Applicant’s Name:
VIADO, JOHN MARTIN CABERTO
Name of School: LA VERNE AACADEMY INC.
School Address:
B.29 L20-23 GOLDEN CITY, IMUS CAVITE

I am applying for SHS-GRADE 11.


This is to certify that I have not enrolled in any school/college/university SHS-GRADE 11 before.

This is to certify that the information above is true and correct. I understand that any
misdeclaration and withholding of information employed by me or on my behalf in
relation to this shall be a ground for non-admission or exclusion from DLSU-D.

VIADO, JOHN MARTIN CABERTO VIADO, CRISOSTOMO GERARDO DEL ROSARIO


------------------------------------------------ --------------------------------------------------------
Signature over printed name of applicant Signature over printed name of parent/guardian
Date:-------------------------------------------

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