Application No.

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ONE RECENT
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Ateneo Junior High School

APPLICATION FOR GRADE 7 ADMISSION
IMPORTANT: Applicants may take the entrance test for Grade 7 only once.

PERSONAL INFORMATION
LEGAL NAME
_________________________________________________________________________________________________________
(Name on Birth Certificate)

LAST NAME

GIVEN NAME

MIDDLE (Give Full Middle Name)

HOME ADDRESS
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
ZIP CODE __________ TEL. NO. _______________ MOBILE NO. _______________ EMAIL ________________________________
Would you prefer to receive notification via this email address? [ ] YES [ ] NO

DATE OF BIRTH _______________ PLACE OF BIRTH ____________________ CITIZENSHIP __________ RELIGION _____________
FATHERS NAME ______________________________________________________________________ [ ] LIVING [ ] DECEASED
CITIZENSHIP _______________ RELIGION _______________ OCCUPATION ___________________________________________
MOTHERS NAME _____________________________________________________________________ [ ] LIVING [ ] DECEASED
CITIZENSHIP _______________ RELIGION _______________ OCCUPATION ___________________________________________
GUARDIANS NAME (If applicable) ____________________________________________________________________________
ADDRESS
_________________________________________________________________________________________________________
RELATION TO APPLICANT __________________________________ OCCUPATION ______________________________________
TEL. NO. _______________ MOBILE NO. _______________ EMAIL _____________________________________________
Would you prefer to receive notification via this email address? [ ] YES [ ] NO

SCHOLASTIC BACKGROUND
List all schools you attended beginning from the lowest grade.
ELEMENTARY SCHOOL

LOCATION

GRADE(S)
Grade _____ to _____ SY _____ to _____
Grade _____ to _____ SY _____ to _____
Grade _____ to _____ SY _____ to _____

HIGH SCHOOL

LOCATION

YEAR(S)
Year _____ to _____ SY _____ to _____

Have you ever applied to the Ateneo de Manila Junior High School prior to this application? _____ YES _____ NO
If YES, when? ________________________________________ For what grade level? ___________________________________

Grade 7 Admission Application Form

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List your extra-curricular activities,

including positions held

List any honors or awards you have

received for scholastic achievement

List your community or church activities

Were you ever dismissed from any school or denied re-admission? _____ YES _____ NO. If YES, provide name of school, school
year and reason(s).
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Did you ever repeat a grade level? _____ YES _____ NO. If YES, provide name of school, school year and reason(s).
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Were you ever placed on probation status? _____ YES _____ NO. If YES, provide name of school, school year and reason(s).
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Did you encounter academic difficulties in the past? _____ YES _____ NO. If YES, please describe.
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Were you ever diagnosed with conditions that prevented you from performing well in school, e.g. ADHD? _____ YES _____ NO.
If YES, please describe.
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Name of the Principal, Headmaster or Director of your present school _______________________________________________
School Address
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Tel. No. ____________________ Email ______________________________

HEALTH AND PHYSICAL FITNESS

Date of your last physical exam
Name of physician

_________________________________________________________
_________________________________________________________

List any health problems/medical conditions which should be taken into consideration in planning your school activities.
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Grade 7 Admission Application Form
_________________________________________________________________________________________________________
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Have you ever been forced to stop schooling for a month or more because of poor health? _____ YES _____ NO. If YES, provide
details and dates.
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________

AUTOBIOGRAPHY
Please write a brief handwritten autobiography touching on the following points: your chief interests, ambitions,
accomplishments, and your desire to pursue your education at the Ateneo de Manila. This is an important part of your
application and a good opportunity to make yourself known to the committee that will process applications for Grade 7. Take
time to think about what you will write and give attention to the fundamentals of good writing (content, organization, and
mechanics such as grammar and spelling). Make sure not to simply repeat information already provided in other pages of this
form. Limit your autobiography to one side of one (1) sheet of size A4 bond paper.

FINANCIAL AID
Are you applying for Financial Aid from the Ateneo? _____ YES _____ NO. If YES, secure a copy of the Financial Aid Application
form from the Ateneo Junior High School Administration Office. The form may also be downloaded from this link:
www.ateneo.edu by selecting Junior High School from the dropdown menu under Schools. Fill up the questionnaire and
provide a complete set of required documents before submitting the same to the Ateneo Junior High School Admistration
Office together with this application form. Financial Aid Forms with incomplete requirements will not be processed.

RECOMMENDATIONS
Give the names and addresses of the persons who can send your Letters of Recommendation if requested by the Admissions
Committee. Choose two (2) persons who know you well and who have held positions of authority over you in your present
school (ex. teacher, counselor or principal). Do not include relatives or friends.
Name

Position

Address

CERTIFICATION
I hereby certify that all information supplied in this application is accurate and complete, and I authorize Ateneo de Manila Junior
High School to verify all information supplied herein. I further certify that I have not applied for the same grade level at the
Ateneo de Manila prior to this application. I fully understand that misrepresentation of information supplied herein will be
considered sufficient reason both for refusal of admission and exclusion.
Fathers/Guardians Signature _________________________

Applicants Signature _________________________

Mothers/Guardians Signature _________________________

Date _________________________

--------------------------------------------------DO NOT WRITE BELOW THIS LINE----------------------------------------------Date Application Received ____________________

Date of Decision ____________________
Date of Notification ____________________
Action of the Admissions Committee:
[ ] ACCEPTED

[ ] P1

[ ] P2

[ ] WAIT-LISTED

[ ] REJECTED

[ ] ____________________

NOTES/COMMENTS

Grade 7 Admission Application Form

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