Application Form

UNIVERSITY OF ST. LA SALLE - BACOLOD THEO PLAN A PROGRAM

APPLICATION FORM Please type or Print legibly surname

given name

middle name

nickname

NAME: ADDRESS: Provincial Address (if you're only staying in a boarding house in Bacolod)

Course, Yr & Sec

ID No

Birthday Religion

Tuition Category Mobile Nos. Home PhoneNo Email Address

Baptismal Date Baptismal Place High School you graduated from: Parish Name & Address Current RS Teacher Father's Name Dad's Work & Business Address Mother's Name Mom's Work & Business Address Guardian's Name Guardian's Work & Business Address

Gende r Blood Type

current RS Schedule Dad's contact No. Mom's contact no. Contact No

What are your reasons for joining the Theo Plan A Program:

What are the talents which you can share with the Theo Plan A Program:

PASTE YOUR RECENT 2X2 COLORED ID PICTURE HERE

THEO PLAN A COMMITMENT I, __________________________, am applying to be a volunteer catechist of the University of St La Salle through the Theo Plan A Program. I am willing to abide with the policies of the Program and I understand that in lieu of my attendance to my RS classes, as a volunteer I have to set aside 1 hour of my vacant period every week to go and teach catechism to the public elementary school where I will be assigned and I promise that I will faithfully adhere to the obligations and regulations of the Theo Plan A Volunteer. I commit myself to Christian service. Conforme: (signature over printed name of applicant)

(signature over printed name of applicants' parents or guardian)

Approved by: (Theo Plan A Moderator)

a b c d

Note: Bring this form during interview. other documents to bring: 1. Evaluation Form: fully accomplished by your RS1 or RS2 Professor and sealed in an envelope 2. Baptismal Certificate