Information Registration

Sign Up

Disclaimer: This form is hosted on a secure server and can only be viewed by the school authority. Please feel confident in filling out this form, as all of your information will be kept safe with every step of the process. This web application respects confidentiality agreement.

LRN

Your LRN is a 12 digit number assigned to you by your school.

This email will be used for authenticating in the dashboard.

Password

Your password must be at least 8 characters long and include at least one uppercase letter, one lowercase letter, one number, and one special character.

Confirm Password

Name

Grade

Section

Date of Birth

Address

Are you a person with disability?

Picture

Please upload a recent and valid picture of yourself. The picture must have a plain background.

Emergency Contact 1

Full Name

The full name of your emergency contact.

Phone Number

The phone number of your emergency contact.

Facebook Profile

The link to the facebook profile of your emergency contact.

Relationship

How are you related to your emergency contact?

Emergency Contact 2

Full Name

The full name of your emergency contact.

Phone Number

The phone number of your emergency contact.

Facebook Profile

The link to the facebook profile of your emergency contact.

Relationship

How are you related to your emergency contact?

Emergency Contact 3 (Optional)

Full Name

The full name of your emergency contact.

Phone Number

The phone number of your emergency contact.

Facebook Profile

The link to the facebook profile of your emergency contact.

Relationship

How are you related to your emergency contact?