PRINT or TYPE all information and attach one 2x2 photograph above.

Submit this form together with the other requirements to

the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level: Second Year

Program: BTTE

PERSONAL INFORMATION
Last Name: Mijares
First Name: Edelyn
Middle Name: Mendoza

COMPLETE ADDRESS: Purok 1, Brgy. Quezon, Lipa City

DATE OF BIRTH: 12/30/1999 CIVIL STATUS: Single

PLACE OF BIRTH: Caloocan City Metro Manila GENDER: Female
MOBILE NUMBER: 09366864825 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 24

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Cumba-Quezon Elementary School 2008-2014
JUNIOR HIGH
Lipa City National High School 2014-2018
SENIOR HIGH
ICT-Ed Institute of Science and Technology 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Eduardo A. Mijares Marilyn Silva Mendoza
AGE 68 54

Incase of Emergency please notify

Contact Person: Jeric Elrey L. Sayson

Contact Number: 09165426716

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level: First Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Villanueva
First Name: Abigaile Esther
Middle Name: Rafael

COMPLETE ADDRESS: Brgy pinagkawitan lipa city

DATE OF BIRTH: 12/31/1999 CIVIL STATUS: Married

PLACE OF BIRTH: Taguig City Metro Manila GENDER: Female
MOBILE NUMBER: 09609176682 RELIGION: Christian
E-MAIL ADDRESS: [email protected]
AGE: 26

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
La mesa elementary school 2009-2010
JUNIOR HIGH
Alternative Learning System 2013-2014
SENIOR HIGH
N/A N/A
Previous School if
College City College of Calamba 2020-2021
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Efren Rafael Anna Marie Trocio
AGE 58 55

Incase of Emergency please notify

Contact Person: Frank Villanueva

Contact Number: 09179092599

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level: First Year

Program: BSEN

PERSONAL INFORMATION
Last Name: Lindog
First Name :Rhea mae
Middle Name: Medrano

COMPLETE ADDRESS: Pinagkawitan lipa city

DATE OF BIRTH: 1/1/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa city GENDER: Female
MOBILE NUMBER: 09668713945 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 18

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Pinagkawitan elementary school 2017
JUNIOR HIGH
Pinagkawitan national high school 2021
SENIOR HIGH
Pinagkawitan intergratednational high school 2023
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Emiliano lindog Meriam medrano
AGE 49 45

Incase of Emergency please notify

Contact Person: Rhea lindog

Contact Number: 09668713945

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:First Year

Program: BSOA

PERSONAL INFORMATION
Last Name: valeras
First Name:maridel
Middle Name: ebora

COMPLETE ADDRESS: san nicolas st.brgy.balintawak lipa city

DATE OF BIRTH: 1/2/2000 CIVIL STATUS: Single

PLACE OF BIRTH: san juan batangas GENDER: Female
MOBILE NUMBER: 09774796990 RELIGION: roman catholic
E-MAIL ADDRESS: [email protected]
AGE: 34

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
bacawan elementary school 1997-2003
JUNIOR HIGH
domingo yu chu national high school 2003-2006
SENIOR HIGH
N/A N/A
Previous School if
College eastern mindoro institute of science and technology 2006-2007
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME rodelio saez valeras marilyn ebora valeras
AGE 55 50

Incase of Emergency please notify

Contact Person: reggie valeras

Contact Number: 09153165339

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSEN

PERSONAL INFORMATION
Last Name: Vergara
First Name:John Patrick
Middle Name: Manzanila

COMPLETE ADDRESS: Brgy. Rizal Lipa city

DATE OF BIRTH: 1/3/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Brgy. Rizal Lipa City GENDER: Male
MOBILE NUMBER: 09152231653 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 19

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Rizal Elementary School 2015-2016
JUNIOR HIGH
Rizal Junior high school 2019-2020
SENIOR HIGH
Lipa Senior High School 2021-2022
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Marlon Vergara Niña Vergara
AGE 50 49

Incase of Emergency please notify

Contact Person: Mother

Contact Number: 09455863270

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Leynes
First Name:Loida
Middle Name: Diaz

COMPLETE ADDRESS: Purok 2, Banay-Banay, Padre Garcia, Batangas

DATE OF BIRTH: 1/4/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Banay-Banay, Padre Garcia, Batangas GENDER: Female
MOBILE NUMBER: 09266387917 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Banay-Banay Elementary School 2014-2015
JUNIOR HIGH
Padre Garcia Integrated National Highschool 2018-2019
SENIOR HIGH
Padre Garcia Integrated National Highschool 2020-2021
Previous School if
College Polytechnic University of the Philippines 2021-2022
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Bernabe Matulac Leynes Lina Laylo Diaz
AGE 49 47

Incase of Emergency please notify

Contact Person: Lina D. Leynes

Contact Number: 09068462635

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:First Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Maandal
First Name:Earl Justin
Middle Name: Camo

COMPLETE ADDRESS: Anilao labac lipa city batangas

DATE OF BIRTH: 1/5/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Anilao labac lipa city batangas GENDER: Male
MOBILE NUMBER: 09913274001 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 18

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Pinagkawitan elementary school 2018-2019
JUNIOR HIGH
Pinagkawitan integrated national high school 2021-2022
SENIOR HIGH
Pinagkawitan integrated national high school 2020-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Nestor C. Maandal Redelyn camo maandal
AGE 67 42

Incase of Emergency please notify

Contact Person: Rowena camo

Contact Number: 09552296129

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Rocafort
First Name:Mark
Middle Name: Enriquez

COMPLETE ADDRESS: Bukal Padre Garcia Batangas

DATE OF BIRTH: 1/6/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Rosario Batangas GENDER: Male
MOBILE NUMBER: 09513379811 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Bukal Elementary School 2012-2013
JUNIOR HIGH
Bukal Integrated National High School 2017-2018
SENIOR HIGH
Padre Vicente Garcia Memorial Academy 2019-2022
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Willie Zara Rocafort Patricia Enriquez Rocafort
AGE 52 54

Incase of Emergency please notify

Contact Person: WILLIE ZARA ROCAFORT

Contact Number: 09551400574

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Dimayuga
First Name:Leine
Middle Name: Dalwampo

COMPLETE ADDRESS: Brgy. Tangob Lipa City Batangas

DATE OF BIRTH: 1/7/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Sariaya Quezon GENDER: Female
MOBILE NUMBER: 09676572986 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Bucal Elementary School 2010-2016
JUNIOR HIGH
Lipa City National Highschool 2016-2020
SENIOR HIGH
St. Agustine School of Nursing 2020-2022
Previous School if
College NA N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Alfredo Dimayuga Lorna Deblois Dalwampo
AGE 65 57

Incase of Emergency please notify

Contact Person: Lanie D. Vendiola

Contact Number: 09659015784

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Iglesia
First Name:Lyka Mari
Middle Name: Gadi

COMPLETE ADDRESS: Purok 1 Sampaga San Antonio Quezon

DATE OF BIRTH: 1/8/2000 CIVIL STATUS: Single

PLACE OF BIRTH: San Antonio Quezon GENDER: Female
MOBILE NUMBER: 09515541612 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 24

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Pury Elementary School 2005-2012
JUNIOR HIGH
Recto Memorial National High School 2012-2016
SENIOR HIGH
Recto Memorial National High School 2016-2018
Previous School if
College The University of Manila 2018
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Elmer Espedillon Iglesia Lilibeth Jacolbia Gadi
AGE 54 54

Incase of Emergency please notify

Contact Person: Elmer E. Iglesia

Contact Number: 09481065844

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:First Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Perile
First Name:Dainier
Middle Name: Briones

COMPLETE ADDRESS: Pinagkawitan Lipa City Batangas

DATE OF BIRTH: 1/9/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Pinagkawitan Lipa City Batangas GENDER: Male
MOBILE NUMBER: 09927344543 RELIGION: Born again christian
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Pinagkawitan Elementary School 2011-2017
JUNIOR HIGH
Pinagkawitan Integrated National High Schooll 2017-2021
SENIOR HIGH
Pinagkawitan Integrated National High School 2021-2023
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Recesmero L. Perile Merlinda B. Perile
AGE 62 60

Incase of Emergency please notify

Contact Person: Dainier Perile

Contact Number: 09927344543

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Hernandez
First Name:Mayrel
Middle Name: Palian

COMPLETE ADDRESS: Lodlod,Lipa City

DATE OF BIRTH: 1/10/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa city GENDER: Female
MOBILE NUMBER: 09458147196 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 23

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Lodlod Elementary School 2006-2012
JUNIOR HIGH
Lodlod National Highschool 2012-2016
SENIOR HIGH
AMA Computer College Lipa 2016-2018
Previous School if
College NA NA
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Dionisio M.Hernandez Irene Palian
AGE 68 54

Incase of Emergency please notify

Contact Person: Irene Hernandez

Contact Number: 09759484270

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Mendoza
First Name:Kaye Dianne
Middle Name: Balali

COMPLETE ADDRESS: Antipolo Del Norte Lipa City

DATE OF BIRTH: 1/11/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Antipolo Del Norte Lipa City GENDER: Female
MOBILE NUMBER: 09947202250 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 19

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Don Leon E. Dolor Memorial School 2015-2016
JUNIOR HIGH
Lip City National High School 2019-2020
SENIOR HIGH
Pinagkawitan Integrated National High School 2021-2022
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Noriel Mendoza Jeanilita Rosari Balila
AGE 50 45

Incase of Emergency please notify

Contact Person: Kaye Dianne Mendoza

Contact Number: 09947202250

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Garcia
First Name:Symon
Middle Name: Solito

COMPLETE ADDRESS: Bulacnin lipa city batangas

DATE OF BIRTH: 1/12/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Antipolo Del Norte GENDER: Male
MOBILE NUMBER: 09919412960 RELIGION: Filipino
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Don leon dolor memorial school 2005-2010
JUNIOR HIGH
National High School 2011-2015
SENIOR HIGH
Ict-Ed 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Elmer Garvia Ruby Garcia
AGE 41 40

Incase of Emergency please notify

Contact Person: Ruby Garcia

Contact Number: 09122961485

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Bobis
First Name:Michelle
Middle Name: Garcia

COMPLETE ADDRESS: Antipolo del norte lipa city

DATE OF BIRTH: 1/13/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Antipolo Del Norte Lipa City GENDER: Female
MOBILE NUMBER: 09939364297 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 19

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Don Leon Dolor Memorial School 2015-2016
JUNIOR HIGH
Pinagkawitan Integrated National High School 2019-2020
SENIOR HIGH
Pinagkawitan Integrated National High School 2021-2022
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Paul Victor Bobis Evelyn De torres Garcia
AGE 45 49

Incase of Emergency please notify

Contact Person: 09939364297

Contact Number: 09939364527

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:First Year

Program: BSAIS

PERSONAL INFORMATION
Last Name: Silva
First Name:Nathaniel
Middle Name: Dimayuga

COMPLETE ADDRESS: 8.v malabanan

DATE OF BIRTH: 1/14/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa city Batangas GENDER: Male
MOBILE NUMBER: 09455674135 RELIGION: Inc
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Teodoro m kalaw memorial school 2014-2015
JUNIOR HIGH
New era university 2019-2020
SENIOR HIGH
2020-2021 Ict ed
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Daniel silva Marites datu
AGE 50 51

Incase of Emergency please notify

Contact Person: 09668713945

Contact Number: 09668713945

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Tenorio
First Name:Angelica Mae
Middle Name: Sason

COMPLETE ADDRESS: 148 Purok 4 Pagolingin West, Lipa City

DATE OF BIRTH: 1/15/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Pagolingin West, Lipa City GENDER: Female
MOBILE NUMBER: 09089394924 RELIGION: Born Again
E-MAIL ADDRESS: [email protected]
AGE: 19

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Pagolingin Elementary School 2010-2016
JUNIOR HIGH
Anilao National High School 2016-2019
SENIOR HIGH
St. Augustine School of Nursing 2020-2022
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Pantaleon Tenorio Edna Villanueva Sason
AGE 76 54

Incase of Emergency please notify

Contact Person: Edna Tenorio

Contact Number: 09301811940

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Maligo
First Name:Mae Ann
Middle Name: Medrano

COMPLETE ADDRESS: Marawoy Lipa City

DATE OF BIRTH: 1/16/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Antipolo Del Sur Lipa City GENDER: Female
MOBILE NUMBER: 09154755063 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 26

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Labonan Elementary School 2003-2009
JUNIOR HIGH
Vicente B. Ylagan National Highschool 2012-2014
SENIOR HIGH
NA NA
Previous School if
College Kolehiyo ng Lungsod ng Lipa 2015
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Elpidio Galario Maligo Marlene Agojo Medrano
AGE 60 50

Incase of Emergency please notify

Contact Person: Mhelvin Saberola

Contact Number: 09660723387

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSAIS

PERSONAL INFORMATION
Last Name: Gado
First Name:Warren
Middle Name: Bacuac

COMPLETE ADDRESS: Purok 2, Brgy. Balintawak, Lipa City

DATE OF BIRTH: 1/17/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa City GENDER: Male
MOBILE NUMBER: 09454123805 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Abundio Torre Memorial Elementary 2009-2015
JUNIOR HIGH
Lipa City National High School 2015-2019
SENIOR HIGH
Lipa City Senior High School 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Arjudy Gado Nena Bacuac
AGE 47 46

Incase of Emergency please notify

Contact Person: Mother

Contact Number: 09453770346

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Hisita
First Name:Joan
Middle Name: Clete

COMPLETE ADDRESS: Antipolo del norte

DATE OF BIRTH: 1/18/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Magallanes sorsogon GENDER: Female
MOBILE NUMBER: 09508489553 RELIGION: Roman catholic
E-MAIL ADDRESS: [email protected]
AGE: 25

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Bulala elemntary school 2004-2010
JUNIOR HIGH
N/A N/A
SENIOR HIGH
N/A N/A
Previous School if
College Magallanes National Vocational High school 2011-2014
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Domingo E. Hisita Isabelita Clete
AGE 64 49

Incase of Emergency please notify

Contact Person: Claire Escurido

Contact Number: +639261372239

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSEN

PERSONAL INFORMATION
Last Name: Fadrigon
First Name:Michelle
Middle Name: Fortu

COMPLETE ADDRESS: Blk 11 Lot 11 Pangao Lipa City Batangas

DATE OF BIRTH: 1/19/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Tambo Lipa City GENDER: Female
MOBILE NUMBER: 09633883375 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 19

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Balogo Elementary School 2011-2016
JUNIOR HIGH
Los Banos National High School 2016-2020
SENIOR HIGH
Los Banos Senior High School 2021-2022
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Rene Fadrigon Marygrace Fortu
AGE 0 46

Incase of Emergency please notify

Contact Person: Marygrace Fetalino

Contact Number: 09102547539

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Marfil
First Name:Gherol ruiz
Middle Name: Escalona

COMPLETE ADDRESS: Brgy. Antipolo del Norte, Lipa City

DATE OF BIRTH: 1/20/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa City GENDER: Male
MOBILE NUMBER: 09368087624 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 19

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Jose K. Obando Memorial Elementary School 2010-2016
JUNIOR HIGH
Pinagkawitan Integrated National High School 2016-2020
SENIOR HIGH
Pinagkawitan Integrated National High School 2020-2022
Previous School if
College na na
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Rowel B. Marfil Romana Escalona Fortuna
AGE 40 49

Incase of Emergency please notify

Contact Person: Rowel Marfil

Contact Number: 09368087624

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSAIS

PERSONAL INFORMATION
Last Name: Valencia
First Name:Princess
Middle Name: Gonzales

COMPLETE ADDRESS: Purok 7 Brgy Lumbang Lipa City

DATE OF BIRTH: 1/21/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lumbang Lipa City GENDER: Female
MOBILE NUMBER: 09975011240 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 19

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Lumbang Elementary School 2013-2018
JUNIOR HIGH
Lumbang Integrated National High School 2018-2020
SENIOR HIGH
Lumbang Integrated National High School 2020-2022
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Rolly Valencia Josephine Marasigan Gonzales
AGE 49 51

Incase of Emergency please notify

Contact Person: Mother

Contact Number: 09550933536

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Rosales
First Name:John Daniel
Middle Name: Untalan

COMPLETE ADDRESS: Bugtong napulo Lipa City

DATE OF BIRTH: 1/22/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa City GENDER: Male
MOBILE NUMBER: 09695695236 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Bugtong napulo elementary school 2010-2016
JUNIOR HIGH
Bugtong napulo intergrated national highschool 2016-2019
SENIOR HIGH
Bugtong napulo intergrated national highschool 2020-2022
Previous School if
College NA Na
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Rio M. Rosales Melanie U. Rosales
AGE 52 45

Incase of Emergency please notify

Contact Person: Rio Rosales

Contact Number: 90190743480

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:First Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Mercado
First Name:Ron Ron
Middle Name: Sanchez

COMPLETE ADDRESS: Pinagkawitan Lipa city Batangas

DATE OF BIRTH: 1/23/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa city GENDER: Male
MOBILE NUMBER: 09319506573 RELIGION: Born again Christian
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Pinagkawitan elementary school 2010-2016
JUNIOR HIGH
Pinagkawitan integrated national high school 2009-2013
SENIOR HIGH
Pinagkawitan integrated national high school 2020-2023
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Rolando Moster Mercado Crispina Sanchez Mercado
AGE 59 49

Incase of Emergency please notify

Contact Person: 09506474920

Contact Number: 00319506563

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSCS

PERSONAL INFORMATION
Last Name: De Luna
First Name:Jholia Angelica
Middle Name: Olivia

COMPLETE ADDRESS: Purok 5, Brgy. San Jose Lipa City

DATE OF BIRTH: 1/24/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Brgy. San Jose, Lipa City GENDER: Female
MOBILE NUMBER: 0955 516 5802 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 19

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Jose Integrated School 2010-2016
JUNIOR HIGH
Lipa City National High School 2016-2020
SENIOR HIGH
ICT-ED Institute of Science and Technology 2020-2022
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Jose Bautista De Luna Mergilda Rabino Olivia
AGE 42 42

Incase of Emergency please notify

Contact Person: Mergilda O. De Luna

Contact Number: 0955 516 5802

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:First Year

Program: BSEN

PERSONAL INFORMATION
Last Name: Fadriquela
First Name:Gerald
Middle Name: Mirandilla

COMPLETE ADDRESS: Brgy. Sico, Sitio Pakalat, Lipa City

DATE OF BIRTH: 1/25/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lodlod, Lipa City GENDER: Male
MOBILE NUMBER: 09914144260 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Lodlod Elementary School 2009-2015
JUNIOR HIGH
Lodlod Integrated National High School 2015-2019
SENIOR HIGH
STI College Lipa 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Ronald Ferranco Fadriquela Luningning Seva Mirandilla
AGE 51 51

Incase of Emergency please notify

Contact Person: Gerald Fadriquela

Contact Number: 09914144260

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Fermante
First Name:Babylyn
Middle Name: Bustamante

COMPLETE ADDRESS: San nicolas balintawak lipa city

DATE OF BIRTH: 1/26/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa batangas GENDER: Female
MOBILE NUMBER: 09395230918 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Fernando Air Base elementary school 2009-2015
JUNIOR HIGH
Fernando air base national high school 2015-2018
SENIOR HIGH
St Augustine school of nursing lipa 2017-2018
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Eddie Fermante Lydia Fermante
AGE 51 52

Incase of Emergency please notify

Contact Person: Lydia Fermante

Contact Number: 0955 826 6133

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSOA

PERSONAL INFORMATION
Last Name: LIRIT
First Name:ROSE MARI
Middle Name: CAGUITLA

COMPLETE ADDRESS: Block 42, Lot 6, Bella Vita Subdivision, Anilao Lipa City

DATE OF BIRTH: 1/27/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa City, Batangas GENDER: Female
MOBILE NUMBER: 09359085895 RELIGION: CATHOLIC
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Anilao Elementary School 2007-2014
JUNIOR HIGH
Anilao National High School 2014-2018
SENIOR HIGH
ICT-ED Institute of Science and Technology 2018-2019
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME RENANTE KATIGBAK LIRIT JENNIFER ICARO CAGUITLA
AGE 53 45

Incase of Emergency please notify

Contact Person: Jennifer Caguitla Lirit

Contact Number: 09924936749

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Mercado
First Name:Leslie Anne
Middle Name: Daguplo

COMPLETE ADDRESS: #460 Purok 7 Brgy. Anilao Lipa City Batangas

DATE OF BIRTH: 1/28/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Anilao Lipa City GENDER: Female
MOBILE NUMBER: 09382104519 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Anilao Elementary School 2007-2014
JUNIOR HIGH
Anilao Integrated National High School 2014-2018
SENIOR HIGH
ICTED Lipa Campus 2018-2019
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Florencio De Ocampo Mercado Antonia Daguplo Mercado
AGE 59 49

Incase of Emergency please notify

Contact Person: Antonia D. Mercado

Contact Number: 09812242961

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSEN

PERSONAL INFORMATION
Last Name: Aseron
First Name:Frank Daved
Middle Name: De Vera

COMPLETE ADDRESS: Sampaguita, San Antonio, Quezon

DATE OF BIRTH: 1/29/2000 CIVIL STATUS: Single

PLACE OF BIRTH: San Antonio Quezon GENDER: Male
MOBILE NUMBER: 09108568247 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 23

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Poblacion, San Antonio, Central School 2008-2014
JUNIOR HIGH
Pansol, National Highschool 2014-2017
SENIOR HIGH
Ict-Ed Institute of Science and Technology at Poblacion San Antonio Quezon 2017-2020
Previous School if
College Ict-Ed Institute of Science and Technology Lipa City, Batangas 2020-2024
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Sonny Boy Aseron Jennifer Aseron
AGE 44 42

Incase of Emergency please notify

Contact Person: Jennifer Aseron

Contact Number: 09709431344

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSOA

PERSONAL INFORMATION
Last Name: cañelas
First Name:evette
Middle Name: de ocampo

COMPLETE ADDRESS: Purok 7 Anilao Lipa City

DATE OF BIRTH: 1/30/2000 CIVIL STATUS: Single

PLACE OF BIRTH: lipa city GENDER: Female
MOBILE NUMBER: 09753552483 RELIGION: catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
anilao elem school 2008-2009
JUNIOR HIGH
anilao national high school 2015-2017
SENIOR HIGH
ict ed 2018-2020
Previous School if
College n/a n/a
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME edwin celia de ocampo
AGE 46 46

Incase of Emergency please notify

Contact Person: celia canelas

Contact Number: 09939654024

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Geronimo
First Name:Abigail
Middle Name: Bayer

COMPLETE ADDRESS: Pinagsibaan Rosario Batangas

DATE OF BIRTH: 1/31/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Rosario Batangas GENDER: Female
MOBILE NUMBER: 09635249751 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Pinagsibaan Elementary School 2009-2014
JUNIOR HIGH
Santo Rosario Academy 2014-2018
SENIOR HIGH
Santo Rosario Academy 2018-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Manuel Untalan Geronimo Jesselyn Caya Bayer
AGE 44 43

Incase of Emergency please notify

Contact Person: Jesselyn Geronimo

Contact Number: 09635249751

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:First Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Villarosa
First Name:Neil Alieson
Middle Name: Espiritu

COMPLETE ADDRESS: San Ignacio Rosario Batangas

DATE OF BIRTH: 2/1/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Capas, Tarlac GENDER: Male
MOBILE NUMBER: 09465534908 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 19

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Capas Gabaldon Elementary School 2010-2016
JUNIOR HIGH
Rosario Integrated National High School 2016-2020
SENIOR HIGH
Rosario Integrated National High School 2021-2023
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Nelson M. Villarosa Leslie L. Espiritu
AGE 51 51

Incase of Emergency please notify

Contact Person: 09465480219

Contact Number: 09465534908

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Dimayuga
First Name:Kristle Joy
Middle Name: Mercado

COMPLETE ADDRESS: Brgy. Sampaguita, San Antonio, Quezon

DATE OF BIRTH: 2/2/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Brgy.Sampaguita, San Antonio, Quezon GENDER: Female
MOBILE NUMBER: +639919533543 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Antonio Central School 2008-2013
JUNIOR HIGH
San Antonio National Highschool 2014-2018
SENIOR HIGH
ICT-Ed Institute of Science and Technology 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Rolando Dimayuga Victoria Dimayuga
AGE 51 50

Incase of Emergency please notify

Contact Person: Victoria Dimayuga

Contact Number: 09914372893

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Salvacion
First Name:Jhon Neil
Middle Name: Kalaw

COMPLETE ADDRESS: Brgy San Jose,Lipa City Batanggas Phil

DATE OF BIRTH: 2/3/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa city GENDER: Male
MOBILE NUMBER: +639914820270 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Jose Integrated School 2010-2016
JUNIOR HIGH
Lipa City National high school 2016-2019
SENIOR HIGH
Lipa City Senior High school 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Onofre Salvacion Iluminada Salvacion
AGE 64 61

Incase of Emergency please notify

Contact Person: Ruth Angeli Custodio

Contact Number: +639568910870

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Laresma
First Name:John Noriel
Middle Name: Rubio

COMPLETE ADDRESS: Purok8 Torres Subdivisions, Brgy. Namunga, Rosario, Batangas

DATE OF BIRTH: 2/4/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Namunga, Rosario, Batangas GENDER: Male
MOBILE NUMBER: 09632809379 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Rosario, West, Central, School 2007-2014
JUNIOR HIGH
Sto.Niño Formation and Science School 2014-2019
SENIOR HIGH
St. Augustine School of Nursing (Lipa Campus) 2019-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Ariel Aloria Laresma Norlyn Rubio Laresma
AGE 50 44

Incase of Emergency please notify

Contact Person: 09533597224

Contact Number: 09632809379

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSEN

PERSONAL INFORMATION
Last Name: Rabino
First Name:Gio Carlo
Middle Name: Enriquez

COMPLETE ADDRESS: purok 5 brgy rizal lipa city

DATE OF BIRTH: 2/5/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa City GENDER: Male
MOBILE NUMBER: 0945-834-7839 RELIGION: Protestant
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Rizal Elementary school 2013-2014
JUNIOR HIGH
Rizal National highschool 2017-2018
SENIOR HIGH
STI College Lipa 2019-2020
Previous School if
College KLL 2021-2022
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Gregorio Rabino Analene Enriquez Rabino
AGE 53 43

Incase of Emergency please notify

Contact Person: 09150272811

Contact Number: 09605668242

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Rodriguez
First Name:Sarah Jane
Middle Name: Magdasoc

COMPLETE ADDRESS: 316, Sitio Santa Margarita, Brgy. Munting Tubig, Ibaan Batangas

DATE OF BIRTH: 2/6/2000 CIVIL STATUS: Single

PLACE OF BIRTH: MVM Rosario Hospital GENDER: Female
MOBILE NUMBER: 09636815011 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Gregorio Sison Memorial Elementary School 2008-2014
JUNIOR HIGH
Rizal National High School 2014-2018
SENIOR HIGH
ICT-ED Institute of Science and Technology 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Sandy Torres Rodriguez Ebeth Bermil Sebanes
AGE 41 38

Incase of Emergency please notify

Contact Person: Ebeth Bermil Sebanes

Contact Number: 09634833934

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:First Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Briones
First Name:John Paul
Middle Name: Autentico

COMPLETE ADDRESS: Purok 7 San Roque Rosario Batangas

DATE OF BIRTH: 2/7/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Poblacion B , Rosario Batangas GENDER: Male
MOBILE NUMBER: 09913204792 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Rosario West Central School 2012-2018
JUNIOR HIGH
Rosario National High School 2018-2021
SENIOR HIGH
Rosario Integrated National High School 2021- 2023
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Cenon Basilan Briones Carolina Autentico Briones
AGE 52 50

Incase of Emergency please notify

Contact Person: Carolina Autentico Briones

Contact Number: 09513357064

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Gonzaga
First Name:Jay Anthony
Middle Name: Ais

COMPLETE ADDRESS: Sitio Bayante, Pinagtung-ulan San Jose, Batangas

DATE OF BIRTH: 2/8/2000 CIVIL STATUS: Single

PLACE OF BIRTH: San Jose Batangas GENDER: Male
MOBILE NUMBER: 09384221257 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Jose Elementary School 2011-2013
JUNIOR HIGH
San Jose National High school 2013-2018
SENIOR HIGH
Pinagtung-ulan Integrated National High school 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Prospero Payos Gonzaga Mylene Reyes Ais
AGE 50 47

Incase of Emergency please notify

Contact Person: Mylene Gonzaga

Contact Number: 09481370349

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Titular
First Name:Eric
Middle Name: Separa

COMPLETE ADDRESS: Talisay Lipa City

DATE OF BIRTH: 2/9/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Talisay Lipa City GENDER: Male
MOBILE NUMBER: 09660722813 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 23

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Talisay Elementary School 2007-2012
JUNIOR HIGH
Lumbang National High School 2012-2017
SENIOR HIGH
AMA Senior High School 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Ricardo Titular Lita Separa
AGE 60 55

Incase of Emergency please notify

Contact Person: Rica Titular

Contact Number: 09660722813

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Linatoc
First Name:Loren
Middle Name: Llanes

COMPLETE ADDRESS: Purok 7, 204 Lumbang Lipa city Batangas

DATE OF BIRTH: 2/10/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lumbang Lipa City GENDER: Female
MOBILE NUMBER: 09953467525 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Lumbang Elementary School 2007-2014
JUNIOR HIGH
Lumbang Integrated National High School 2014-2018
SENIOR HIGH
ICT-ED Institute of Science and Technology Inc. 2018-2019
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Bonifacio Espiritu Linatoc Eusebia Linatoc Llanes
AGE 60 63

Incase of Emergency please notify

Contact Person: Michelle Linatoc

Contact Number: 09272374297

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BTTE

PERSONAL INFORMATION
Last Name: De Chavez
First Name:Mark Ryan
Middle Name: Dolormente

COMPLETE ADDRESS: 275 Munting Tubig Ibaan Batangas

DATE OF BIRTH: 2/11/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Parañaque GENDER: Male
MOBILE NUMBER: 09265134233 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Gregorio Sison Memorial Elementary School 2007-2014
JUNIOR HIGH
Rizal National High School 2014-2018
SENIOR HIGH
Dr.Juan A Pastor Memorial National High School 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Marcelo Acebo De Chavez Rowena Lucariza Dolormente
AGE 48 46

Incase of Emergency please notify

Contact Person: Rowena De Chavez

Contact Number: 09095581933

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BTTE

PERSONAL INFORMATION
Last Name: Rodriguez
First Name:Edralyn
Middle Name: Dequina

COMPLETE ADDRESS: Brgy. Bawi, Padre Garcia, Batangas

DATE OF BIRTH: 2/12/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Mataas na Kahoy, Batangas GENDER: Female
MOBILE NUMBER: 09151339075 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 26

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Juan A. Amparo Elementary School 2008-2009
JUNIOR HIGH
Pansol National High School 2012-2013
SENIOR HIGH
N/A N/A
Previous School if
College Lipa City Colleges 2016-2017
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Edgar Rodriguez Emily Rodriguez
AGE 53 54

Incase of Emergency please notify

Contact Person: Emily Rodriguez

Contact Number: 09516111528

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BTTE

PERSONAL INFORMATION
Last Name: Cortez
First Name:Rosalyn
Middle Name: De Ramos

COMPLETE ADDRESS: Maugat East Padre Garcia Batangas

DATE OF BIRTH: 2/13/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Maugat East Padre Garcia Batangas GENDER: Female
MOBILE NUMBER: 09633283577 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Maugat East Elementary School 2009-2014
JUNIOR HIGH
Bukal National High School 2015-2018
SENIOR HIGH
ICT-ED Institute of Science and Technology 2019-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Exequiel Carandang Cortez Vilma Diola De Ramos
AGE 55 51

Incase of Emergency please notify

Contact Person: Rosalyn Cortez

Contact Number: 09633283577

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Bagting
First Name:Bernadette
Middle Name: Culiat

COMPLETE ADDRESS: Baybayin Rosario batangas

DATE OF BIRTH: 2/14/2000 CIVIL STATUS: Live-in

PLACE OF BIRTH: Rosario batangas GENDER: Female
MOBILE NUMBER: 09705276982 RELIGION: Roman catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Rosario East Central School 2009-2015
JUNIOR HIGH
Baybayin National High School 2015-2017
SENIOR HIGH
Baybayin National High School 2017-2019
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Jayson Maderazo Bagting Marilou lunar Culiat
AGE 40 41

Incase of Emergency please notify

Contact Person: Marilou Bagting

Contact Number: 09121807357

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Andal
First Name:Clark
Middle Name: Jose

COMPLETE ADDRESS: Jokers St. Brgy Poblacion, San Antonio, Quezon

DATE OF BIRTH: 2/15/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Valenzuela, Metro Manila GENDER: Male
MOBILE NUMBER: 09464608937 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Antonio Infotech School 2009-2014
JUNIOR HIGH
Ict-ed Institute of Science and Technology 2014-2017
SENIOR HIGH
Ict-ed Institute of Science and Technology 2018-2020
Previous School if
College San Antonio Central School 2008-2009
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Andres Valencia Andal Matilde Rodriguez Jose
AGE 62 52

Incase of Emergency please notify

Contact Person: Matilde Andal

Contact Number: 09100430681

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Dapog
First Name:Jhasmin
Middle Name: Pagcaliwagan

COMPLETE ADDRESS: Purok 6b Brgy. San Jose, Lipa City.

DATE OF BIRTH: 2/16/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa City, Batangas GENDER: Female
MOBILE NUMBER: 09952135197 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Jose Integrated School 2008-2014
JUNIOR HIGH
The Mabini Academy 2014-2018
SENIOR HIGH
Ict Ed Institute of Science and Technology 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Joey Dapog Melanie Pagcaliwagan
AGE 49 42

Incase of Emergency please notify

Contact Person: Melanie Dapog

Contact Number: 09752499216

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Solis
First Name:Angel
Middle Name: Morete

COMPLETE ADDRESS: Arawan, San Antonio, Quezon

DATE OF BIRTH: 2/17/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Arawan, San Antonio, Quezon GENDER: Female
MOBILE NUMBER: 09381693124 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Arawan, Elementary, School 2010-2015
JUNIOR HIGH
San Antonio, National High School 2015-2019
SENIOR HIGH
San Antonio, National High School 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Rene Pasia Solis Rosario Oroso Morete
AGE 52 46

Incase of Emergency please notify

Contact Person: Rosario Solis

Contact Number: 09090403703

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Rimandiman
First Name:Rhealyn
Middle Name: Magsino

COMPLETE ADDRESS: Sitio Balete , Arawan San Antonio Quezon

DATE OF BIRTH: 2/18/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Arawan, San Antonio, Quezon GENDER: Female
MOBILE NUMBER: 09942210962 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Arawan Elementary School 2010- 2015
JUNIOR HIGH
San Antonio National High School 2015 -2019
SENIOR HIGH
San Antonio National High School 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Petronilo Argona Rimandiman Edna Gonda Magsino
AGE 48 47

Incase of Emergency please notify

Contact Person: Edna Rimandiman

Contact Number: 09387462275

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Tenorio
First Name:Mae
Middle Name: Hernandez

COMPLETE ADDRESS: 096.Sitio Centro. Brgy Magsaysay San Antonio Quezon

DATE OF BIRTH: 2/19/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Magsaysay, San Antonio, Quezon GENDER: Female
MOBILE NUMBER: 09078560540 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Magsaysay Elementary School 2007-2013
JUNIOR HIGH
Callejon National High School 2013-2019
SENIOR HIGH
ICT-ED Institute of Science and Technology. San Antonio Quezon Campus 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Noli Estolano. Tenorio Violeta Din. Hernandez
AGE 46 50

Incase of Emergency please notify

Contact Person: Violeta Tenorio

Contact Number: 0949110567

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BTTE

PERSONAL INFORMATION
Last Name: Olbis
First Name:Ma. Daniela
Middle Name: Fiecas

COMPLETE ADDRESS: Anilao Lipa City Batangas

DATE OF BIRTH: 2/20/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Tambo lipa city GENDER: Female
MOBILE NUMBER: 09944658335 RELIGION: Roman catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Anilao Elementary School 2014-2015
JUNIOR HIGH
Anilao National High School 2018-2019
SENIOR HIGH
St. Augustine school of nursing-lipa city 2020-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Daniel Carbonilla Olbis Maricris Fabunan Fiecas
AGE 50 48

Incase of Emergency please notify

Contact Person: Maricris/ Daniel olbis

Contact Number: 09918834614/09936462700

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BTTE

PERSONAL INFORMATION
Last Name: Wagan
First Name:Jinky
Middle Name: Castillo

COMPLETE ADDRESS: Sitio Manaog, Baranggay Bagong Niing San Antonio Quezon

DATE OF BIRTH: 2/21/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Bagong Niing GENDER: Female
MOBILE NUMBER: 09076659512 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 23

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Sampaga Elementary School 2007-2014
JUNIOR HIGH
San Antonio National Highschool ANNEX 2014-2018
SENIOR HIGH
ICTED (Institute of Science and Technology) 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Nestor Cornejo Wagan Marilou De Castro Catillo
AGE 61 60

Incase of Emergency please notify

Contact Person: Moneth Wagan

Contact Number: 09076659501

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSEN

PERSONAL INFORMATION
Last Name: De Castro
First Name:John Ferdy
Middle Name: Ocampo

COMPLETE ADDRESS: Sampaguita San Antonio Quezon

DATE OF BIRTH: 2/22/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Sampaguita San Antonio Quezon GENDER: Male
MOBILE NUMBER: 9489461810 RELIGION: Romantic Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Antonio Central School 2013-2014
JUNIOR HIGH
Pansol Integrated School 2018-2019
SENIOR HIGH
Padre Garcia National High school 2019 - 2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Ferdinand de castro Catherine De Castro
AGE 43 42

Incase of Emergency please notify

Contact Person: Ferdinand de castro

Contact Number: 9489461810

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Sayson
First Name:John Lawrence
Middle Name: Latorre

COMPLETE ADDRESS: Sitio Pulo purok 2, Brgy. Tangob Lipa City Batangas Pahilippines

DATE OF BIRTH: 2/23/2000 CIVIL STATUS: Live-in

PLACE OF BIRTH: Tangob Lipa City GENDER: Male
MOBILE NUMBER: 09655492040 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Tangob Elementary School 2008-2014
JUNIOR HIGH
Lipa City National High School 2014-2018
SENIOR HIGH
ICT-ED 2018-2020
Previous School if
College KLL 2022-2022
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Marvin Roda Sayson Janeth Caiga Latorre
AGE 41 41

Incase of Emergency please notify

Contact Person: Marvin Sayson/Janeth Sayson

Contact Number: 099913261639

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSOA

PERSONAL INFORMATION
Last Name: chico
First Name:kimberly
Middle Name: maderazo

COMPLETE ADDRESS: pagolingin east lipa city

DATE OF BIRTH: 2/24/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa city GENDER: Female
MOBILE NUMBER: 09165437020 RELIGION: catholic
E-MAIL ADDRESS: [email protected]
AGE: 23

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
pagolingin east elem school 2012-2013
JUNIOR HIGH
Anilao national high school 2014-2017
SENIOR HIGH
ICT ED 2017-2019
Previous School if
College n/a n/a
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME reynaldo magaling chico rodora caraan maderazo
AGE 46 54

Incase of Emergency please notify

Contact Person: 09165437020

Contact Number: 09165437020

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Palo
First Name:Jenny Ann
Middle Name: Racoma

COMPLETE ADDRESS: Brgy.1 ,Bontog Mataasnakahoy Batangas

DATE OF BIRTH: 2/25/2000 CIVIL STATUS: Single

PLACE OF BIRTH: nangkaan GENDER: Female
MOBILE NUMBER: 09657433680 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Nangkaan Elementary School 2009-2015
JUNIOR HIGH
Bayorbor National High School 2015-2019
SENIOR HIGH
Mataasnakahoy Senior High School 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Ronald G. Palo Felecisima R. Palo
AGE 52 52

Incase of Emergency please notify

Contact Person: Felecisima Palo

Contact Number: 09126031762

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BTTE

PERSONAL INFORMATION
Last Name: An
First Name:Roselyn
Middle Name: Reyes

COMPLETE ADDRESS: 220 Sitio, kadiwa Macalamcam B. Rosario, Batangas

DATE OF BIRTH: 2/26/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Macalamcam B. Rosario, Batangas GENDER: Female
MOBILE NUMBER: +639610279413 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Macalamcam B. Elementary School 2008-2014
JUNIOR HIGH
Macalamcam B. National Highschool 2014-2018
SENIOR HIGH
Alupay National Highschool 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Rodolfo Candelaria An Shirley Gonzales Reyes
AGE 50 44

Incase of Emergency please notify

Contact Person: Rodolfo An

Contact Number: 09944469750

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: TENEDERO
First Name:AILYN
Middle Name: ESCAMILLAS

COMPLETE ADDRESS: Balat atis San Antonio Quezon

DATE OF BIRTH: 2/27/2000 CIVIL STATUS: Single

PLACE OF BIRTH: San Pablo laguna GENDER: Female
MOBILE NUMBER: 09633321677 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Pury Elementary school 2008-2015
JUNIOR HIGH
Sanhs Annex 2015-2019
SENIOR HIGH
Ict Ed institute of science and technology San Antonio 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Alfredo Tenedero Gina Escamillas
AGE 51 47

Incase of Emergency please notify

Contact Person: Alfredo Tenedero Jr.

Contact Number: 09633321677

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Salvacion
First Name:Bryan Ivan
Middle Name: Quizon

COMPLETE ADDRESS: Brgy San Jose Lipa City Batangas

DATE OF BIRTH: 2/28/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Brgy San Jose Lipa City GENDER: Male
MOBILE NUMBER: 09065814149 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Jose Elementary School 2009-2015
JUNIOR HIGH
Lipa City National High School 2015-2019
SENIOR HIGH
Ict-ed Institute of Science and Technology 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Jorge M. Salvacion Marcela C. Quizon
AGE 45 44

Incase of Emergency please notify

Contact Person: Jorge Salvacion

Contact Number: 09083464794

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSCS

PERSONAL INFORMATION
Last Name: De Mesa
First Name:Tricia
Middle Name: Maderazo

COMPLETE ADDRESS: Purok3,Brgy.Salao, Rosario,Batangas

DATE OF BIRTH: 2/29/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Brgy.Salao, Rosario, Batangas GENDER: Female
MOBILE NUMBER: 09104415218 RELIGION: Catholic(Born Again Christian)
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Salao East Elementary School 2005-2014
JUNIOR HIGH
Macalamcam B, National High School 2014-2018
SENIOR HIGH
Alupay Intergated National High School 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Virgillo Pascua De Mesa Josefina Manguerra Maderazo
AGE 66 63

Incase of Emergency please notify

Contact Person: Josefina De Mesa

Contact Number: 09309193829

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Mendoza
First Name:Maricar
Middle Name: Palma

COMPLETE ADDRESS: Barangay 8, Cuenca Batangas

DATE OF BIRTH: 3/1/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Martin Marasigan Memorial Hospital GENDER: Female
MOBILE NUMBER: 09158690425 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Cuenca Central Elementary School 2006-2012
JUNIOR HIGH
Cuenca National High School 2013-2017
SENIOR HIGH
Cuenca Senior High School 2018-2019
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Nonilon Alcoran Mendoza Iluminada Chavez Palma
AGE 58 61

Incase of Emergency please notify

Contact Person: Iluminada P. Mendoza

Contact Number: 09054216086

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Morada
First Name:Andrei Ishrael
Middle Name: Joson

COMPLETE ADDRESS: Antipolo del Norte, Lipa City Batangas

DATE OF BIRTH: 3/2/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa City, Batangas GENDER: Male
MOBILE NUMBER: 09938685306 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Don Leon Dolor Elementary School 2008-2014
JUNIOR HIGH
Pinagkawaitan Integrated National High School 2014-2018
SENIOR HIGH
STI College Lipa 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Wesley Maranan Morada Judith Arayan Joson
AGE 46 47

Incase of Emergency please notify

Contact Person: 09057277526

Contact Number: 09938685306

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Salvacion
First Name:Jahzeel
Middle Name: Magwari

COMPLETE ADDRESS: 014 Del Rio Street, San Jose Lipa City

DATE OF BIRTH: 3/3/2000 CIVIL STATUS: Single

PLACE OF BIRTH: San Jose,Lipa City GENDER: Male
MOBILE NUMBER: 09554060422 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 23

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Jose Elementary School 2011-2012
JUNIOR HIGH
Lipa City National High School 2016-2017
SENIOR HIGH
Academia De Lipa 2018-2019
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Nicasio C. Salvacion Luz M. Salvacion
AGE 66 65

Incase of Emergency please notify

Contact Person: Joyce M. Salvacion

Contact Number: 09972668317

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Acuña
First Name:Jarrell
Middle Name: Bae

COMPLETE ADDRESS: Santiago Malvar Lynville 2 blk3 Lot 8

DATE OF BIRTH: 3/4/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lumang Bayan San Teodoro Oriental Mindoro
GENDER: Male
MOBILE NUMBER: 09997905809 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Norther Mindoro Academy 2008-2014
JUNIOR HIGH NMA-2014-2016 ~
Nothern Mindoro Academy ~ The Mabini Academy
TMA 2016-2018
SENIOR HIGH
Institute of Science and Technology 2019-2024
Previous School if
College The mabini Academy N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Rouel Guia Acuña Sherma Bae Acuña
AGE 55 43

Incase of Emergency please notify

Contact Person: Jarrell Acuña

Contact Number: 09997905809

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BTTE

PERSONAL INFORMATION
Last Name: De Mesa
First Name:Trixie
Middle Name: Maderazo

COMPLETE ADDRESS: Purok 3, Barangay Salao, Rosario, Batangas

DATE OF BIRTH: 3/5/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Salao, Rosario Batangas GENDER: Female
MOBILE NUMBER: 09467570300 RELIGION: 4-A
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Salao East Elementary School 2005-2014
JUNIOR HIGH
Macalamcam B National High School 2014-2018
SENIOR HIGH
Alupay Integrated National High School 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Virgilio Pascua De Mesa Josefina Manguerra Maderazo
AGE 67 64

Incase of Emergency please notify

Contact Person: 09467570300

Contact Number: 09467570300

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Valencia
First Name:Shane Aila
Middle Name: Manalo

COMPLETE ADDRESS: Lumbang Lipa City

DATE OF BIRTH: 3/6/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lumbang Lipa City GENDER: Female
MOBILE NUMBER: 09771425954 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Lumbang Elementary School 2013-2014
JUNIOR HIGH
Lumbang Integrated National High School 2017-2018
SENIOR HIGH
ICT-ED "Institute of Science and Technology" 2019-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Antonio Silva Valencia Marcelina Manalo Valencia
AGE 66 57

Incase of Emergency please notify

Contact Person: Marcelina Valencia

Contact Number: 09915993533

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BTTE

PERSONAL INFORMATION
Last Name: Roxas
First Name:Mark Anthony
Middle Name: Roca

COMPLETE ADDRESS: Barangay Lumbang, Lipa City

DATE OF BIRTH: 3/7/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa City GENDER: Male
MOBILE NUMBER: 09664106257 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 24

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Lumbang Elementary School 2009-2010
JUNIOR HIGH
Lumbang National High School 2014- 2015
SENIOR HIGH
N/A N/A
Previous School if
College LCCTD Tesda Lipa 2016
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Joselito V. Roxas Genalen F. Roca
AGE 49 50

Incase of Emergency please notify

Contact Person: Joselito V. Roxas

Contact Number: 09451308603

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Papila
First Name:Rosen Mae
Middle Name: Sancho

COMPLETE ADDRESS: Purok 1 Tangway Lipa City, Batangas

DATE OF BIRTH: 3/8/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Sebaste, Sibunag, Guimaras GENDER: Female
MOBILE NUMBER: 09362114225 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Tangway Elementary School 2011-2014
JUNIOR HIGH
Fernando Air Base Integrated National High School 2014-2018
SENIOR HIGH
ICT-ED Institute of Science and Technology 2018-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Jonathan A. Mondejar Analisa S. Papila
AGE 37 48

Incase of Emergency please notify

Contact Person: Analisa S. Papila

Contact Number: 09359083899

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:First Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Lina
First Name:Allysa Jane
Middle Name: Hernandez

COMPLETE ADDRESS: Purok VB Paninsingin Tambo, Lipa City Batangas

DATE OF BIRTH: 3/9/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Rosario, Batangas GENDER: Female
MOBILE NUMBER: 09939104007 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 18

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Itlugan Elementary Schooo 2011 -2017
JUNIOR HIGH
Lodlod Integrated National High School 2017-2021
SENIOR HIGH
Lodlod Integrated National High School 2021-2023⁸
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Aries Lumbera Lina Lea Hernandez Lina
AGE 45 48

Incase of Emergency please notify

Contact Person: Aries Lina

Contact Number: 09183503123

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BTTE

PERSONAL INFORMATION
Last Name: Dayson
First Name:Ella Mae
Middle Name: Briones

COMPLETE ADDRESS: Callejon San Antonio Quezon

DATE OF BIRTH: 3/10/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Callejon San Antonio Quezon GENDER: Female
MOBILE NUMBER: 09203087973 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Callejon Elementary school 2012-2013
JUNIOR HIGH
Callejon National Highschool 2017-2018
SENIOR HIGH
ICT ED 2020-2021
Previous School if
College ICT ED 2020-2021
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Edwin Dayson Rosemarie Dayson
AGE 47 46

Incase of Emergency please notify

Contact Person: 09307015348

Contact Number: 09307015348

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Vargas
First Name:Michael
Middle Name: De Castro

COMPLETE ADDRESS: Brgy. Loob, San Antonio, Quezon

DATE OF BIRTH: 3/11/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Poblacion, San Antonio, Quezon GENDER: Male
MOBILE NUMBER: 09949312933 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Antonio Central School 2009-2015
JUNIOR HIGH
San Antonio National High School 2015-2019
SENIOR HIGH
San Antonio National High School 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Bernardo Vargas Celerina Vargas
AGE 53 50

Incase of Emergency please notify

Contact Person: 09483554492

Contact Number: 09071976989

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Fourth Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Selverio
First Name:Reymart
Middle Name: Duran

COMPLETE ADDRESS: Pinagkawitan, Lipa City

DATE OF BIRTH: 3/12/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa City GENDER: Male
MOBILE NUMBER: 09611992132 RELIGION: Baptist Christian
E-MAIL ADDRESS: [email protected]
AGE: 23

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Pinagkawitan Elementary School 2007-2013
JUNIOR HIGH
Pinagkawitan National High School 2013-2017
SENIOR HIGH
Pinagkawitan Integrated National High School 2017-2019
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Reynaldo Fernando Selverio Emma Morade Duran
AGE 48 45

Incase of Emergency please notify

Contact Person: Emma D. Selverio

Contact Number: 09944010527

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Mirandilla
First Name:Aldrine Jonard
Middle Name: Morete

COMPLETE ADDRESS: Barangay Arawan San Antonio Quezon

DATE OF BIRTH: 3/13/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Arawan San Antonio GENDER: Male
MOBILE NUMBER: 09197647131 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Arawan elementary school 2010-2016
JUNIOR HIGH
San Antonio National High School 2017-2020
SENIOR HIGH
ICT Ed institute of science and technology 2022-2025
Previous School if
College N/A 2020-2023
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Alexander Mirandilla Arlene Mirandilla
AGE 54 49

Incase of Emergency please notify

Contact Person: Aldrine

Contact Number: 09197647131

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Dumaran
First Name:Daisy
Middle Name: Misola

COMPLETE ADDRESS: Blk10 Lot7 Livorno St. Sorrento Subd. Brgy. Pinagkawitan Lipa City Batangas

DATE OF BIRTH: 3/14/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Las Piñas City GENDER: Female
MOBILE NUMBER: 09515609178 RELIGION: Iglesia Ni Cristo
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Gawaran Elementary School 2009-2015
JUNIOR HIGH
Pinagkawitan Integrated National High School 2015-2019
SENIOR HIGH
ICT-ED Institute of Science and Technology 2019-2021
Previous School if
College ICT-ED Institute of Science and Technology 2021-present
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Elbert R. Dumaran Marissa D. Misola
AGE 56 39

Incase of Emergency please notify

Contact Person: Marissa Misola

Contact Number: 09515609178

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Linatoc
First Name:John Mark
Middle Name: Pusag

COMPLETE ADDRESS: Bukal PG Bats

DATE OF BIRTH: 3/15/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Quilo quilo south pg bats GENDER: Male
MOBILE NUMBER: 09318801567 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Payapa elementary school 2008-2015
JUNIOR HIGH
Padre garcia integrated national highschool 2015-2019
SENIOR HIGH
Padre garcia integrated national highschool 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Joel Visleño Linatoc Marife Luces Pusag
AGE 52 48

Incase of Emergency please notify

Contact Person: Jomar Linatoc

Contact Number: 09913834458

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Second Year

Program: BSEN

PERSONAL INFORMATION
Last Name: Lipay
First Name:Kobe bryan
Middle Name: Eguia

COMPLETE ADDRESS: 467, purok 7, Brgy, Anilao Lipay city

DATE OF BIRTH: 3/16/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Lipa city GENDER: Male
MOBILE NUMBER: 09686294219 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Anilao Elementary school 2009-2015
JUNIOR HIGH
Anilao National Highschool 2015-2019
SENIOR HIGH
Lipa City Senior HighSchool 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME N/A Evelyn Estrera Eguia
AGE 0 57

Incase of Emergency please notify

Contact Person: Evelyn E. lipay

Contact Number: 09128345101

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Mangundayao
First Name:Maxxinne
Middle Name: Guevarra

COMPLETE ADDRESS: Sitio Putuhan, Brgy. Cawongan, Padre Garcia, Batangas

DATE OF BIRTH: 3/17/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Pansol Patik, Padre Garcia, Batangas GENDER: Female
MOBILE NUMBER: 9774417392 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Tangob Elementary School 2009-2015
JUNIOR HIGH
Pansol National High School 2015-2019
SENIOR HIGH
ICT-ED INSTITUTE OF SCIENCE AND TECHNOLOGY 2019-2021
Previous School if
College ICT-ED INSTITUTE OF SCIENCE AND TECHNOLOGY 2021-Present
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Arnold Bolaños Mangundayao Julie Ann Guevarra
Mangundayao
AGE 44 44

Incase of Emergency please notify

Contact Person: Julie Ann G. Mangundayao

Contact Number: 09398443257

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Vergara
First Name:Khyna Evane
Middle Name: Cuenca

COMPLETE ADDRESS: 598, San Miguel, Padre Garcia, Batangas

DATE OF BIRTH: 3/18/2000 CIVIL STATUS: Single

PLACE OF BIRTH: San Miguel, Padre Garcia, Batangas GENDER: Female
MOBILE NUMBER: 09928831310 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Miguel Elementary School 2009-2015
JUNIOR HIGH
Holy Trinity School 2015-2019
SENIOR HIGH
Holy Trinity School 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Ruel C. Vergara Milani Alinea Cuenca
AGE 52 50

Incase of Emergency please notify

Contact Person: Evelyn T. Cuenca

Contact Number: 0999-501-3227 / 0915-701-3308 / 0991-840-4384

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Katapang
First Name:Gabriel
Middle Name: Misamin

COMPLETE ADDRESS: Brgy. Tipacan lipa city Batangas

DATE OF BIRTH: 3/19/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Dasmarinas GENDER: Male
MOBILE NUMBER: 09510108849 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 24

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Tipacan elementary school 2011-2012
JUNIOR HIGH
N/A N/A
SENIOR HIGH
N/A N/A
Previous School if
College Alternative learning system 2016-2016
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Juan E. Katapang Eva joy misamin
AGE 60 46

Incase of Emergency please notify

Contact Person: Juan e katapang

Contact Number: 09567221748

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Malapitan
First Name:Sherelyn
Middle Name: Cueto

COMPLETE ADDRESS: Cawongan, Padre Garcia Batangas

DATE OF BIRTH: 3/20/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Bulsa, San Juan Batangas GENDER: Female
MOBILE NUMBER: 09426736578 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Padre Garcia Central School 2014-2015
JUNIOR HIGH
Padre Garcia National High School 2015-2019
SENIOR HIGH
Padre Garcia Senior High School 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Elpidio Malapitan Cristina Cueto Malapitan
AGE 53 50

Incase of Emergency please notify

Contact Person: 09664190385

Contact Number: 09426736578

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:First Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Rebosura
First Name:Patricia Vernice
Middle Name: Rosario Batangas

COMPLETE ADDRESS: Bellavita Block 57 Lot 14 Anilao Lipa City

DATE OF BIRTH: 3/21/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Batangas City GENDER: Female
MOBILE NUMBER: 09750214387 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 20

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Bugtongnapulo Elementary School 2010-2016
JUNIOR HIGH
Sorsogon National High School 2016-2020
SENIOR HIGH
St. Augustine School of Nursing 2020-2022
Previous School if
College St. Augustine School of Nursing 2022-2023
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Joebel L. Magtubo Catherine G. Rebosura
AGE 45 39

Incase of Emergency please notify

Contact Person: Catherine G. Rebosura

Contact Number: 09488885458

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level:First Year

Program: BSCS

PERSONAL INFORMATION
Last Name: Gaspar
First Name:Allen Gabriel
Middle Name: Silva

COMPLETE ADDRESS: Purok 7 Pinagkawitan, Lipa City Batangas Phillipines

DATE OF BIRTH: 3/22/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Pinagkawitan, Lipa City Batangas GENDER: Male
MOBILE NUMBER: 09944009180 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 18

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Pinagkawitan, Elementary School 2011-2017
JUNIOR HIGH
Pinagkawitan Integrated National High School 2017-2021
SENIOR HIGH
Pinagkawitan Integrated National High School 2021-2023
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Allan Lajara Gaspar Leni Sison Silva
AGE 48 38

Incase of Emergency please notify

Contact Person: Leni Sison Silva

Contact Number: 09812227780

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level :Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Elis
First Name :Joana
Middle Name: Metas

COMPLETE ADDRESS: Brgy. Mabini Lipa City, Batangas

DATE OF BIRTH: 3/23/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Latag Lipa City, Batangas GENDER: Female
MOBILE NUMBER: 09854048884 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 22

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Guillermo Elementary School 2010-2014
JUNIOR HIGH
Rizal National High School 2014-2018
SENIOR HIGH
Ict-ed Institute of Science and Technology 2018-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Joselito L. Elis Myrna C. Metas
AGE 48 53

Incase of Emergency please notify

Contact Person: Myrna Elis

Contact Number: 0912 779 1476

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level: Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Linatoc
First Name: Maezzy Anne
Middle Name: Quintana

COMPLETE ADDRESS: Barangay Sampaguita, San Antonio, Quezon

DATE OF BIRTH: 3/24/2000 CIVIL STATUS: Single

PLACE OF BIRTH: San Antonio, Quezon GENDER: Female
MOBILE NUMBER: 09305162715 RELIGION: Roman Catholic
E-MAIL ADDRESS: [email protected]
AGE: 21

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
San Antonio Central School 2008-2015
JUNIOR HIGH
San Antonio National High School 2015-2019
SENIOR HIGH
ICT-ED Institute of Science and Technology 2019-2021
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME Ramon De Guzman Linatoc Louvette Marino Quintana
AGE 45 43

Incase of Emergency please notify

Contact Person: Ramon Linatoc

Contact Number: 09129106295

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level :Third Year

Program: BSOA

PERSONAL INFORMATION
Last Name: Mendoza
First Name :Rose Ann
Middle Name: Gutierrez

COMPLETE ADDRESS: brgy,bubuyan mataasnakahoy bats.

DATE OF BIRTH: 3/25/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Baco oriental mindoro GENDER: Female
MOBILE NUMBER: 09486584252 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 23

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
bubuyan elementary school 2012-2013
JUNIOR HIGH
mataasnakahoy national high school 2018-2019
SENIOR HIGH
airbase 2019-2020
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME avelino Mendoza Gemma Mendoza
AGE 50 45

Incase of Emergency please notify

Contact Person: Avelino Mendoza

Contact Number: 09486584252

WISDOM-FAITH-SERVICE REVISED : March 21, 2019

 PRINT or TYPE all information and attach one 2x2 photograph above. Submit this form together with the other requirements to
the ICT-ED Admissions Office. ONLY APPLICATIONS WITH CORRECT AND COMPLETE INFORMATION/REQUIREMENTS WILL BE
PROCESSED.

Year Level: First Year

Program: BSEN

PERSONAL INFORMATION
Last Name: Cruzit
First Name: Kevin Roi
Middle Name: Balanquit

COMPLETE ADDRESS: Purok 4, Antipolo Del Sur Lipa City Batangas

DATE OF BIRTH: 3/26/2000 CIVIL STATUS: Single

PLACE OF BIRTH: Antipolo Del Sur Lipa City GENDER: Male
MOBILE NUMBER: 09923003496 RELIGION: Catholic
E-MAIL ADDRESS: [email protected]
AGE: 18

EDUCATIONAL BACKGROUND

LEVEL NAME OF PREVIOUS SCHOOL LAST YEAR

ATTENDED
ELEMENTARY
Jose K. Obando Memorial Elementary School 2010-2017
JUNIOR HIGH
Pinagkawitan Integrated National High School 2017-2021
SENIOR HIGH
Pinagkawitan Integrated National High School 2021-2023
Previous School if
College N/A N/A
Transferee/Vocational

FAMILY BACKGROUND

INFORMATION FATHER MOTHER

NAME June Medrano Cruzit Ma. Lea Gutaba Balanquit
AGE 45 39

Incase of Emergency please notify

Contact Person: Ma. Lea B. Cruzit

Contact Number: 09150617208

WISDOM-FAITH-SERVICE REVISED : March 21, 2019