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ICI GITAGUM
SENIOR HIGH SCHOOL
I.D NO. 411443
A branch of Iligan Computer Institute Incorporated.
APPLICATION FORM FOR SENIOR HIGH SCHOOL GRADE 11 in JUNE 2026
Please Answer all questions fully in CAPITAL letters.
Please complete and print this form and return to the School Registrar, Monday to Friday, 7:30 to 4:30. You can also obtain a printed copy from the School Registrar. Please note completion and submission of the form does not guarantee a place on any course.

Learner Reference Number

Student Last Name

Student First Name

Student Middle Name

Date of Birth

Gender

Place of Birth

Age

Current or Last School

Current Address

Current Grade if in School or ALS

Last Grade Graduated (If not currently in school or ALS)

Student's preferred Track: Technical Vocational or General Academic

Student's Phone

Student's Email

Parent's/Guardian's Information:

Father/Guardian Last Name

Father/Guardian First Name

Father/Guardian Middle Name

Father/Guardian Contact Number

Mother/Guardian Last Name

Mother/Guardian First Name

Mother/Guardian Middle Name

Mother/Guardian Contact Number

Further Student Information

Does the student or their family currently receive Government Assistance Such as DEPED / PEAC Voucher for High School Education Fees(Full or Partial); The 4P's Benefits, or Local Government Assistance

If Yes, Please Specify what Benefits are received and from whom

If the potential student is related to any current student or member of staff, please state to whom and the nature of the relationship

PLEASE NOTE THAT APPROXIMATELY 80 – 90% OF LESSONS AT SENIOR HIGH SCHOOL ARE IN ENGLISH. STUDENTS MUST ME ABLE TO READ, WRITE, AND SPEAK ENGLISH TO MAKE THE MOST OF THEIR SENIOR HIGH SCHOOL STUDIES.

Parent or guardian, please print full name as signature

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