Online Registration Form SY 2023-2024
Welcome to the UPHSD Las Piñas Online Registration Form!

You will receive a confirmation message for your registration. Please note that this form is only the first step in the reservation process. Additional requirements shall be completed for us to proceed.

Kindly accomplish the online application form below:
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TYPE OF APPLICANT *
STUDENT'S LAST NAME: *
FIRST NAME: *
MIDDLE NAME: *
GRADE LEVEL BEING APPLIED FOR: *
MOBILE NETWORK: *
MOBILE NUMBER: *
LANDLINE NUMBER:
Please type in an active email address to receive the enrollment procedure.
EMAIL ADDRESS:
GENDER: *
DATE OF BIRTH: *
MM
/
DD
/
YYYY
COMPLETE HOME ADDRESS: *
CITY / PROVINCE: *
CURRENT SCHOOL: *
TYPE OF SCHOOL: *
SCHOOL ADDRESS: *
FATHER'S NAME: *
MOBILE NETWORK: *
MOBILE NUMBER: *
MOTHER'S NAME: *
MOBILE NETWORK: *
MOBILE NUMBER: *
DECLARATION COMPLIANT TO THE DATA PRIVACY ACT
I hereby authorize the University of Perpetual Help to collect, process, and use the information for legitimate purposes, including but not limited to answering inquiries, and allow authorized personnel to process the information, store, save, secure, and protect database, and destroy the same in accordance with the laws, rules and regulation. *
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