INTERNATIONAL SCHOOL OF ASIA AND THE PACIFIC
Alimannao Hills, Peñablanca, Cagayan 3502
C OLLEGE OF C RIMINAL JUSTICE EDUCATION
STUDENT INFORMATION SHEET
Student ID Number : ____________________
Course : ____________________
Date Enrolled : ____________________
Contact Number : ____________________
BASIC INFORMATION
Name: __________________________________________________________________________________
(Surname) (First Name) (Middle Name)
Birthdate: __________________ Birthplace: _________________________________________________
Current Address: __________________________________________________________________________
(House No.) (Street No.) (Barangay) (Municipality) (Province)
Home Address: ___________________________________________________________________________
(House No.) (Street No.) (Barangay) (Municipality) (Province)
Nationality: ______________________________ Religion: ________________________________
EDUCATIONAL BACKGROUND
Level PRIMARY SECONDARY TERTIARY
(for second coursers only)
Name of School
Year Graduated
Address
Academic Awards
Special Awards
For transferees and shifters, please indicate the previous course: ____________________________________
Previous School: ___________________________________________________________________________
Address: _________________________________________________________________________________
PERSONAL DATA QUESTIONS
Why did you choose BS in CRIMINOLOY course?
_________________________________________________________________________________________
_________________________________________________________________________________________
Why did you choose International School of Asia and the Pacific to pursue your tertiary education?
_________________________________________________________________________________________
_________________________________________________________________________________________
Notes: 1. Please provide the correct and true data being asked in this form to the best of your knowledge and belief.
2. Please use BLACK BALLPEN in filling out this form and write eligibly by using CAPITAL LETTERS ONLY.
Who prompted you to enrol this course?
Parents Siblings Friends Personal Decision Please specify if other:_________________
Are you experiencing difficulty in studying? Yes No
How often? Always Often Sometimes
If yes, in what aspect? Financial Family Condition Environment Adaptation
If others, please specify: _____________________________________________________________________
What do you do if you encounter problems?
Gets absent in class Drink Liquor Sleep the whole day Pray Talk to friends/ Teachers
If others, please specify: _____________________________________________________________________
Who serves as your inspiration/s in your studying? Family Special Someone Friend
How do you see yourself in the future? _________________________________________________________
How are you going to put your dreams into reality?
_________________________________________________________________________________________
_________________________________________________________________________________________
Please write a simple COMMITMENT STATEMENT to the CHTM and to the school on the box below:
_______________________________
(Signature Over Printed Name)
CONSENT
My personal data provided in this form are true and correct to the best of my knowledge and belief. I have
read this form, understood its contents and given my personal data freely without any presence of intimidation
or force. I understand that my consent in the processing of my personal data does not preclude the existence
of other criteria for lawful processing of personal data and does not waive any of my rights under the Data
Privacy Act of 2012 and other applicable laws.
_______________________________
(Signature Over Printed Name)
Date: __________________________
Notes: 1. Please provide the correct and true data being asked in this form to the best of your knowledge and belief.
2. Please use BLACK BALLPEN in filling out this form and write eligibly by using CAPITAL LETTERS ONLY.
