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: