Legal Name
(Name in Birth Certificate)
LAST NAME
Nickname
Present School
FIRST NAME
MIDDLE NAME
APPLICATION FOR ADMISSION
INCOMING COLLEGE FRESHMAN
LOYOLA SCHOOLS
Office of Admission and Aid
Ateneo Application No.
INSTRUCTIONS
1.
2.
3.
4.
5.
6.
7.
8.
Read the LOYOLA SCHOOLS DEGREE PROGRAMS & SPECIAL NOTES brochure and all instructions very carefully.
Fill out this form carefully and print (using ink) or type all information requested. Only application forms correctly and completely filledout will be accepted. Write N/A if the information is not applicable to you. Omissions can delay the processing of your application.
INCOMPLETE APPLICATION FORMS WILL NOT BE PROCESSED. The application fee is non-refundable.
Submit this form together with the following:
sealed Secondary School Record and
two (2) sealed Recommendation Forms
Personal Essay
Principal’s Recommendation Form
ACET Exam Permit
Acknowledgment Slip
This application form and other requirements must be submitted on or before December 14, 2012, Friday.
The Ateneo College Entrance Test (ACET) will be taken at the Testing Site where this form is submitted.
Those applying for scholarship must ask for a SCHOLARSHIP/FINANCIAL AID QUESTIONNAIRE. Submit the
completed questionnaire together with the application form for admission. If the questionnaire is not available in your school or
testing center, you may secure one from the Office of Admission and Aid or online at www.ateneo.edu/ls-oaa.
(NOTE: Application for financial aid does not, in any way, influence acceptance or non-acceptance into the Loyola Schools.)
Freshman applicants who already graduated from high school must not have taken units or enrolled in any college/university before
and/or during the application period.
PERSONAL INFORMATION
1. Permanent Address:
Unit No. & Bldg. Name
(if applicable)
Street No. & Street Name
City/Municipality & Province
Subdivision/Barangay
Zip Code
Country
2. Mailing Address:
(if not the same as above)
3. Telephone Number:
Unit No. & Bldg. Name
(if applicable)
Street No. & Street Name
Subdivision/Barangay
City/Municipality & Province
Zip Code
(
4. Mobile Number:
)
Country
Area Code
5. Email Address:
6. Birth Date:
/
/
7. Birth Place:
MM / DD / YYYY
8. Citizenship:
Filipino
Dual (specify):
9. Gender:
Other (specify):
M
F
10. Age:
11. Religion:
FAMILY INFORMATION
12.
FATHER
Living
Deceased
MOTHER
Living
Deceased
Name
Telephone
Number
Mobile Number
If college graduate:
from what school?
Year and Degree
graduated
If employed:
Name of company/
employer
PLEASE DO NOT WRITE BELOW THIS LINE
ACCEPTED
WAITLISTED
NOT ACCEPTED
GUARDIAN (if applicable)
13. Sibling/s’ Educational Attainment (eldest to youngest)
Name
School Last Attended
Year Level
Course
Year Graduated
14. Relatives who have attended or are currently attending Ateneo de Manila
Name
Relation
Level / Year & Course
Year Graduated
ACADEMIC INFORMATION
15. Schools Attended (list all schools attended beginning from elementary)
Elementary
Address
High School
Levels Attended
Period Covered
Gr.
to
20
to
20
Gr.
to
20
to
20
Address
Levels Attended
Period Covered
Yr.
to
20
to
20
Yr.
to
20
to
20
NOTE: If you are under a Home School Program, please coordinate with the Office of Admission and Aid.
16. Complete name of Principal / Headmaster
Complete name of Guidance Counselor
17. List any honors or awards you have received for academic excellence in high school or at special events such as science
contests, writing contests, etc. You may use a separate sheet if needed.
Honors / Awards Received
Year Level & Year
18. Were you ever dismissed, suspended or placed on probation?
If yes, indicate the offense, date and penalty:
Yes
Sponsoring Group / Awarded by
No
EXTRA-CURRICULAR ACTIVITIES
19. List your high school extra-curricular activities, including positions held or special responsibilities. You may use a separate sheet.
Activities / Organizations / Varsity Teams
Position/s Held
Year Level/s
If you are a member of your school’s varsity team, indicate the sport and your skill level (check one).
Sport:
Skill Level:
Average
20. List camps or seminars that you attended in Ateneo de Manila:
21. List your community and/or church activities:
High
Superior
OTHER INFORMATION
22. Fitness. List any physical and/or psychological challenges that should be taken into consideration in planning your program of
studies & school activities.
Have you ever been forced to stop schooling for a month or more because of poor health? Give details and dates.
Reason/s
23. Test Site (check one)
Year Level / Dates
Course/s of Action
Ateneo de Manila University – Loyola Heights Campus, Quezon City
Provincial Testing Center (please specify):
International Testing Center (please specify):
Applicants from schools abroad who cannot take the ACET should submit together with this
form the result of their Scholastic Aptitude Test I (SAT I) taken within the last two years.
Indicate the month & year
when SAT I was taken:
/
MM / YYYY
24. List any review class you attended for the ACET:
25. List the schools to which you have applied or intend to apply to (both local and foreign):
If accepted in these schools, will you still go to the Ateneo?
26. List the names and positions of the persons recommending you (persons to whom you gave Recommendation Forms 1&2).
NOTE: Choose two persons who know you well and who are presently holding positions of authority over you in your
present school, e.g. college professor, guidance counselor. Do not submit recommendations from friends or relatives.
1) Name
Position
2) Name
Position
PERSONAL ESSAY
27. In order for the Committee on Admission and Aid to get to know you better, answer the question below in the form of an essay.
“Are there any significant experiences you have had, or accomplishments you have realized,
that have helped to define you as a person?”
Please take this essay seriously. It is a good opportunity to make yourself known to the committee. We presume that you will
take time to think and write this essay carefully, with due attention to correct grammar and fundamentals of good writing style.
You may use either English or Filipino. Please use an A4 sized bond paper.
ON-CAMPUS DORMITORY APPLICATION
28. Are you interested in applying to the Ateneo Residence Halls?
If yes, be sure to get a Dormitory Application Form from the Office of the Residence Halls, Cervini Hall, Ateneo de Manila
University or from the Provincial Testing Center nearest you. For more information on the Ateneo Residence Halls, please call
(+632) 426 6001 local 5901.
I hereby certify that all information written in this application form is complete and accurate. If accepted as a student, I agree that my
admission, matriculation, and graduation are subject to the rules and regulations of the Ateneo de Manila University.
Applicant’s Signature
Parent’s or Guardian’s Signature
Date Signed
Credentials and information filed in support of this application become the property of the Ateneo de Manila
University. Documents submitted are not returnable to the applicant. Misrepresentation of information requested
in this application form and its subsequent attachments will be considered sufficient reason for refusal of
admission and exclusion from the admission process.
RECENT 1”x1”
Photo of
Applicant
Please write your name
at the back of the
photo.
Legal Name
(Name in Birth Certificate)
LAST NAME
FIRST NAME
MIDDLE NAME
SCHOLARSHIP APPLICATION
29. Are you applying for financial aid?
YES
Make sure to submit the SCHOLARSHIP/FINANCIAL AID QUESTIONNAIRE
together with this application form. No decision will be made on your scholarship
application unless you submit the completed scholarship form.
NO
DEGREE PROGRAMS
Rank the degree program you wish to take in order of preference from 1st to 4th. Rank only 4 among all the courses below.
Do not choose more than two (2) Honors Programs. Honors Programs are composed of the Top 15% of ACET examinees only
and are marked by an asterisk ( ).
The choice of degree programs does not influence acceptance or non-acceptance into the Ateneo. If the student is accepted but
is not qualified in the 1st choice, one of the applicant’s other choices will be assigned as the committee deems fit.
School of Humanities (SOH)
BFA Major in Art Management
(BFA AM)
BFA Major in Creative Writing
(BFA CW)
BFA Major in Theater Arts (BFA TA)
AB Humanities (AB HUM)
AB Interdisciplinary Studies (AB IS)
AB Literature-English (AB LIT(ENG))
AB Literature-Filipino
(Filipino-Panitikan) (AB LIT(FIL))
AB Philosophy (AB PH)
AB Philosophy: Pre-Divinity Track
(AB PH-PREDIV)
BFA Major in Information Design
(BFA ID)
School of Social Sciences (SOSS)
AB Chinese Studies (AB CHNS)
AB Communication (AB COM)
AB Development Studies (AB DS)
AB Diplomacy and International
Relations (AB DipIr)
AB Economics (AB EC)
AB Economics-Honors* (AB EC-H)
AB European Studies (AB EU)
AB History (AB HI)
AB Management Economics (AB MEC)
AB Political Science (AB POS)
AB/MA Political Science* (AB-MA POS)
AB/M Political SciencePublic Management* (AB POS-MPM)
AB Psychology (AB PSY)
BS Psychology* (BS PSY)
AB Social Sciences (AB SOS)
School of Science and Engineering (SOSE)
BS Biology* (BS BIO)
BS Chemistry* (BS CH)
BS Chemistry/BS Applied
Computer Systems* (BS CH-ACS)
BS Chemistry/BS Materials Science
and Engineering* (BS CH-MSE)
BS Computer Engineering (BS COE)
BS Computer Science* (BS CS)
BS/MS Computer Science*
BS Electronics and Communications
Engineering (BS ECE)
BS Environmental Science (BS ES)
BS Health Sciences* (BS HSc)
BS Life Sciences* (BS Lf Sci)
BS Management Information Systems
(BS MIS)
BS Management Information Systems/
MS Computer Science* (BSMIS-MSCS)
BS Mathematics* (BS MA)
BS/M Applied Mathematics:
Mathematical Finance* (BSM AMF)
BS Physics* (BS PS)
BS Applied Physics/BS Applied
Computer Systems* (BS PS-ACS)
BS Applied Physics/BS Materials
Science and Engineering* (BS PS-MSE)
(BSMS CS)
John Gokongwei School of Management (JGSOM)
BS Communications Technology
Management (BS COMTECH)
BS Information Technology
Entrepreneurship* (BS ITE)
BS Legal Management (BS LM)
BS Management (BS MGT)
BS Management-Honors* (BS MGT-H)
BS Management Engineering* (BS ME)
BS Management of Applied Chemistry
(BS MAC)
30. At present, what are two (2) of your career preferences? (e.g., businessman, doctor, teacher, etc.) Please do not leave blank.
PLEASE DO NOT WRITE BELOW THIS LINE
INCOMPLETE:
INFERRED:
DEADLINE:
SIGNATURE:
STAMP:
Legal Name
(Name in Birth Certificate)
LAST NAME
FIRST NAME
MIDDLE NAME
Year & Section
SECONDARY SCHOOL RECORD AND
PRINCIPAL’S RECOMMENDATION FORM
LOYOLA SCHOOLS
Office of Admission and Aid
INSTRUCTIONS
To the
Applicant:
Please write your name above using ink.
Give this form to your High School Principal and supply him/her with an envelope.
To the Principal:
The student whose name appears above is applying to the Loyola Schools of the Ateneo de Manila University.
It is important that this form is filled-out accurately and completely.
The information about rank is extremely important – please do not omit your answer for this part.
After filling out this form, please put it in an envelope, seal and sign across the flap and return to the applicant.
Countersign erasures and corrections made. All information will be kept confidential. Thank you for your assistance.
SECONDARY SCHOOL RECORD
YEAR LEVEL
FIRST
ENGLISH
(20
-20
)
SECOND (20
-20
)
THIRD
-20
)
(20
NOTE: Compute the average of the five subjects below for the YEARLY AVERAGE.
FILIPINO
MATH
SOCIAL
STUDIES
SCIENCE
YEARLY
AVERAGE
SUBJECT AVERAGE
1. Rank (Do not omit this.)
a. Number of students in whole graduating class:
b. Rank of applicant in whole batch at the end of third year:
2. Type of Section
Honors
Science Section
Semi-Honors
General
No Honors Section
Science-Oriented
Private Sectarian
Private Non-Sectarian
3. Type of School (Please choose one.)
Public
State University
PRINCIPAL’S RECOMMENDATION
4. Please check if the applicant is a candidate for:
Valedictorian
Salutatorian
Honorable Mention
Other honors (please specify):
5. Has the applicant been involved in any serious disciplinary case (e.g., cheating, stealing, fighting)?
YES
NO
If yes, please state the offense, date & penalty and give your assessment of the student at present.
6. Has the applicant failed any subject/s at the end of any year level in high school?
YES
NO
If yes, please specify the year level, subject and grade obtained.
7. Has the applicant ever repeated a year level in high school?
8. Is the applicant under your high school’s home school program?
YES
NO
Which year level/s?
YES
NO
(Please do not leave this part blank.)
Accomplished by:
(please PRINT name)
Official Name of High School:
Signature:
Position:
Complete Address:
Date:
Name of Principal:
(if not the same as above)
Contact Nos.:
1
Not Applicable
2
3
4
Legal Name
(Name in Birth Certificate)
LAST NAME
FIRST NAME
MIDDLE NAME
Year & Section
RECOMMENDATION FORM 1
LOYOLA SCHOOLS
Office of Admission and Aid
INSTRUCTIONS
To the
Applicant:
Please write your name above using ink.
Give this form to the person who knows you well enough and currently holds a position of authority over you in your
present school (e.g., guidance counselor – for freshman applicants, college professor – for transfer applicants).
Kindly supply him/her with an envelope.
To the Person
Recommending:
The student whose name appears above is applying to the Loyola Schools of the Ateneo de Manila University.
We value your candid and honest evaluation of this applicant. Based on your careful judgment, please fill out this form
completely.
After filling out this form, please put it in an envelope, seal and sign across the flap and return to the applicant.
Countersign erasures and corrections made. All information will be kept confidential. Thank you for your assistance.
GENERAL EVALUATION
(Please check the box that applies.)
Above
Average
Average
Below
Average
No Chance
To Observe
Communication Skills:
Oral
Written
Leadership
Motivation
Consistency of Performance
Emotional Stability
COMMENTS
Your honest evaluation of the applicant will help the Committee on Admission and Aid to decide on his/her application.
(e.g., intellectual strengths and weaknesses, level of maturity, sense of service to school and community)
OVERALL RECOMMENDATION
DO NOT OMIT THIS PART. Please check one.
STRONGLY RECOMMENDED
RECOMMENDED
RECOMMENDED WITH RESERVATION (Please state reasons on the lines provided above or on a separate sheet if needed.)
NOT RECOMMENDED (Please state reasons on the lines provided above or on a separate sheet if needed.)
(Please do not leave this part blank.)
Accomplished by:
Official Name of School:
Signature:
Position:
Complete Address:
Subject taught:
Contact Nos.:
Legal Name
(Name in Birth Certificate)
LAST NAME
FIRST NAME
MIDDLE NAME
Year & Section
RECOMMENDATION FORM 2
LOYOLA SCHOOLS
Office of Admission and Aid
INSTRUCTIONS
To the
Applicant:
Please write your name above using ink.
Give this form to the person who knows you well enough and currently holds a position of authority over you in your
present school (e.g., guidance counselor – for freshman applicants, college professor – for transfer applicants).
Kindly supply him/her with an envelope.
To the Person
Recommending:
The student whose name appears above is applying to the Loyola Schools of the Ateneo de Manila University.
We value your candid and honest evaluation of this applicant. Based on your careful judgment, please fill out this form
completely.
After filling out this form, please put it in an envelope, seal and sign across the flap and return to the applicant.
Countersign erasures and corrections made. All information will be kept confidential. Thank you for your assistance.
GENERAL EVALUATION
(Please check the box that applies.)
Above
Average
Average
Below
Average
No Chance
To Observe
Communication Skills:
Oral
Written
Leadership
Motivation
Consistency of Performance
Emotional Stability
COMMENTS
Your honest evaluation of the applicant will help the Committee on Admission and Aid to decide on his/her application.
(e.g., intellectual strengths and weaknesses, level of maturity, sense of service to school and community)
OVERALL RECOMMENDATION
DO NOT OMIT THIS PART. Please check one.
STRONGLY RECOMMENDED
RECOMMENDED
RECOMMENDED WITH RESERVATION (Please state reasons on the lines provided above or on a separate sheet if needed.)
NOT RECOMMENDED (Please state reasons on the lines provided above or on a separate sheet if needed.)
(Please do not leave this part blank.)
Accomplished by:
Official Name of School:
Signature:
Position:
Complete Address:
Subject taught:
Contact Nos.:
Legal Name
(Name in Birth Certificate)
LAST NAME
FIRST NAME
Contact Nos.:
MIDDLE NAME
Course (1st Choice):
Please write the course code indicated at the back of the Application Form.
Present School:
ATENEO COLLEGE ENTRANCE TEST
FRESHMAN EXAM PERMIT SY2013-2014
LOYOLA SCHOOLS
Office of Admission and Aid
Ateneo Application No. (AAN)
REMINDERS
RECENT 1”x1”
Photo of
Applicant
Please come on time. For Metro Manila examinees, expect heavy traffic.
Late examinees will NOT be allowed to take the test.
REMEMBER to bring this Exam Permit. Examinees without permits cannot take the test.
Bring two (2) sharpened medium lead pencils and ballpens.
Bring snacks (if desired). No one will be allowed to leave the room to buy snacks.
If you have any medical condition that requires special attention, please immediately inform
the Office of Admission and Aid.
Please write your name
at the back of the
photo.
TEST SCHEDULE
METRO MANILA
JANUARY 20, 2013, Sunday, 7:30AM-12:30PM
PROVINCIAL TESTING CENTERS: Xavier University (Cagayan de Oro), Sacred Heart School-Jesuit (Cebu), Ateneo de Davao High School,
Ateneo de Iloilo, Ateneo de Naga High School and Ateneo de Zamboanga High School only. Please verify schedule with the testing center.
JANUARY 19, 2013, Saturday, 7:30AM-12:30PM
TESTING SITE
Applicant’s Signature
FOR OAA USE ONLY. PLEASE DO NOT WRITE ANYTHING BELOW.
METRO MANILA
Validated by:
PROVINCE
Admission Personnel
Legal Name
(Name in Birth Certificate)
LAST NAME
FIRST NAME
Contact Nos.:
MIDDLE NAME
Course (1st Choice):
Please write the course code indicated at the back of the Application Form.
Present School:
ATENEO DE MANILA UNIVERSITY
ATENEO COLLEGE ENTRANCE TEST
FRESHMAN EXAM PERMIT SY2013-2014
LOYOLA SCHOOLS
Office of Admission and Aid
Ateneo Application No. (AAN)
REMINDERS
Please come on time. For Metro Manila examinees, expect heavy traffic.
Late examinees will NOT be allowed to take the test.
REMEMBER to bring this Exam Permit. Examinees without permits cannot take the test.
Bring two (2) sharpened medium lead pencils and ballpens.
Bring snacks (if desired). No one will be allowed to leave the room to buy snacks.
If you have any medical condition that requires special attention, please immediately inform
the Office of Admission and Aid.
RECENT 1”x1”
Photo of
Applicant
Please write your name
at the back of the
photo.
TEST SCHEDULE
METRO MANILA
JANUARY 20, 2013, Sunday, 7:30AM-12:30PM
PROVINCIAL TESTING CENTERS: Xavier University (Cagayan de Oro), Sacred Heart School-Jesuit (Cebu), Ateneo de Davao High School,
Ateneo de Iloilo, Ateneo de Naga High School and Ateneo de Zamboanga High School only. Please verify schedule with the testing center.
JANUARY 19, 2013, Saturday, 7:30AM-12:30PM
TESTING SITE
Applicant’s Signature
FOR OAA USE ONLY. PLEASE DO NOT WRITE ANYTHING BELOW.
METRO MANILA
PROVINCE
Validated by:
Admission Personnel
Acknowledgment Slip
Applicant’s Copy
LOYOLA SCHOOLS
Office of Admission and Aid
Ateneo Application No.:
Legal Name:
Contact No.:
Present School:
DO NOT WRITE BELOW THIS LINE.
Application Form received by:
Date:
Acknowledgment Slip
Admission’s Copy
LOYOLA SCHOOLS
Office of Admission and Aid
Ateneo Application No.:
Legal Name:
Contact No.:
Present School:
DO NOT WRITE BELOW THIS LINE.
Application Form received by:
Date: