AiTECH-Admission-Form1-rev08
City Government of Antipolo
Antipolo Institute of Technology Assigned ID Number Once Applicant is Enrolled
Sito Cabading, Brgy. San Jose
Antipolo City
Admissions Application Form
Submit this application form together with all admission requirements before the 2X2
said deadline. Only complete application will be processed. Covered Picture with
PRINT ALL THE INFORMATION AND AVOID ERASURES. Name
(Taken in the last 6 months)
This form can be reproduced. APPLICANT FOR:
Date of Exam:
Deadline of Submission: College (BCETM)
Name: FLORES CARLO BENDECIO
(Surname) (First Name) (Middle Name)
Date of Birth: 12/02/2004 Place of Birth: ANTIPOLO CITY Contact No.: 09669141858
Age: 19 Gender: MALE BAPTIST
Religion: Email Address:
[email protected]Address: 104 MAGITING ST. PHASE 3-D, PADILLA BRGY. DELA PAZ ANTIPOLO CITY
(Street No.) (Street Name) (Subdivision/Village/Sitio) (Barangay) (City/Municipality)
Number of Years Residing in Rizal:
FATHER MOTHER GUARDIAN
( ) Living ( ) Deceased ( ) Living ( ) Deceased (If applicable)
Name JOSE B. FLORES MARIETTA B. FLORES
Highest Educational Attainment HIGH SCHOOL HIGH SCHOOL
Occupation CONTRACTOR HOUSE KEEPER
Name of Employer
Monthly Family Income 20,000
Annual Gross Family Income: 70,000 Other Source of Income:
2
Number of Children/Dependents in the Family: ___________________Their Ages: 13 AND 19
ACADEMIC BACKGROUND
Name of School Address Year Graduated
ELEMENTARY STA CRUZ ELEMENTARY SCHOOL OLALIO ROAD, BRGY STA. CRUZ 2017
JUNIOR HIGH SCHOOL ANTIPOLO NATIONAL HIGH SCHOOL OLALIA ROAD, BRGY. STA CRUZ 2021
FOR COLLEGE APPLICANT:
SENIOR HIGH SCHOOL ANTIPOLO CITY SENIOR HIGH SCHOOL OLALIA ROAD, BRGY STA. CRUZ 2023
TRACK / STRAND ABM
ADMISSION REQUIREMENTS
For First Year College Applicants
During application:
o Accomplished Antipolo Institute of Technology Application Form with picture
o Certified True Copy of Grade 12 Report Card
o Certificate of Good Moral Character (for college application)
o Photocopy of Birth Certificate issued by the Philippine Statistics Authority (PSA)
If qualified for enrolment:
o Original Copy of Barangay Certificate of Residency
o Income Tax Return or Certificate of Non-Filling of Tax of parents or guardians
o Two (2) Recent Identical 2” x 2” and one (1) 1” x 1” photographs with name taken within the last six
months
o Photocopy of Voter’s Certificate of Parents or Guardians issued by the Commission of Elections
(COMELEC)
o Certificate of Good Moral Character (for enrolment purposes)
