PRE-REGISTRATION FORM

Last School Attended

School Name
School Address
Last Attended
LRN:

Personal Information

Birthday
Gender
Body Index

Birth Place

Home Address

Contact Information

Contact No.

Social Account

Contact Person

Father
Mother
Contact Person

Educational Background

Primary Education
Secondary Education

Referred By :

I Agree, To give my consent to the collection, processing, and disclosure of my personal information to the Admissions Office of the Quezon Institute of Technology, Inc. (QIT) in accordance with R.A. 10173 ( Data Privacy Act of 2012).