MESSIAH COLLEGE Online Registration Form
PERSONAL INFORMATION
ACADEMIC INFORMATION
REFERENCES
PERSONAL INFORMATION
Fields marked with (*) are required. Write N/A if not applicable.
Classification
*
New Student
Continuing Regular Student
Transferee / Irregular
Semester
*
1st Semester
2nd Semster
Academic Year
*
2024-2025
Last Name
*
First Name
*
Middle Name
*
Birthday
*
Birth Place
*
Gender
*
Female
Male
Shirt Size
XS
S
M
L
XL
XXL
Home Address
*
Email Address
*
GMail Account is preferred.
Student's CP No.
*
Facebook/Messenger
Father's Name
*
Mother's Maiden Name
*
Guardian's Name (if any)
Relationship
Parent's/Guardian's CP No.
*
Parent's/Guardian's Email Address
*
How long have you been born again Christian?
less than 1 year
1-3 years
more than 3 years
Church Name
Denomination
Please select
Church Member
Church Attendee
With Ministry
Name & Address of Last School Attended Before Messiah College
Are you presently under medication?
*
YES
NO
If yes, what medication?
Are you presently undergoing counselling?
*
YES
NO
If yes, what reason?
Have you ever undergone psychiatric treatment?
*
YES
NO
If yes, when?
Covid Vaccination Status
*
With booster/s
Fully vaccinated
Unvaccinated
Agree
*
YES
I hereby authorize Messiah College Foundation, Inc. to collect and process the data indicated herein for the purpose of my application for admission, enrollment, or scholarship application / renewal. I understand that my personal information is protected by RA 10173, Data Privacy Act of 2012.
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