Student Pre-Registration

Complete all required information below

PRE-REGISTRATION FORM

Last School Attended

School Name

Awards Received

Year Last Attended

LRN Number

Personal Information

Last Name

The Last Name field is required.

First Name

The First Name field is required.

Middle Name

The Middle Name field is required.

Suffix Name

Nick Name

The Nick Name field is required.

Birthday

Civil Status

Citizenship

The Citizenship field is required.

Religion

Gender

Ethnicity

The Ethnicity field is required.

Body Index

Birth Place

Province

Municipality/City

Home Address

Province

Municipality/City

Contact Information

Contact No.

Social Account

Contact Person

Father

Mother

Contact Person

Educational Background

Primary Education

Secondary Education

Questions

Are you a Child of a Solo Parent?

Are you a Person with Disability (PWD)?

I Agree, To give my consent to the collection, processing, and disclosure of my personal information to the Admissions Office of the DON CARLOS POLYTECHNIC COLLEGE (DCPC) in accordance with R.A. 10173 ( Data Privacy Act of 2012).