APPLICATION FORM
LA CONSOLACION COLLEGE MANILA
8 Mendiola Street, Malacañang Complex, San Miguel, Manila,
Philippines 1005
Trunklines: 8736-0235/ 8310-0513 loc. 150
Email Address: casr_capp@lccm.edu.ph
Website: www.lccm.edu.ph
Paste 2in. x 2in.
YEAR LEVEL: Freshman Transferee Second Course Taker
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GENDER: Male CIVIL STATUS: Single
COLLEGE PROGRAM APPLIED FOR: BSHM - Cruise Ship Management
PERSONAL INFORMATION
NAME: Nanglegan Jethro Cumahling
Last Name First Name Middle Name
DATE OF BIRTH: August 12 2002 PLACE OF BIRTH: Bitu, Hingyon, Ifugao
Month Day Year
NATIONALITY: Filipino RELIGION: Catholic
HOME ADDRESS: Culob, Bitu, Hingyon, Ifugao ZIP Code: 3607
EMAIL ADDRESS: kitnanglegan@gmail.com LANDLINE NO. MOBILE NO. 09772941298
SCHOOL LAST ATTENDED: Lyceum of the Philippines University-Manila YEAR GRADUATED: *2020
SCHOOL ADDRESS: Muralla st, Intramuros , Manila STRAND: ABM
FAMILY BACKGROUND
FATHER’S NAME: Nanglegan Eduard Dulnuan
Last Name First Name Middle Name
OCCUPATION: Police CONTACT NUMBER: 09067151876
MOTHER’S NAME: Nanglegan Marina Cumahling
Last Name First Name Middle Name
OCCUPATION: N/A CONTACT NUMBER:
GUARDIAN’S NAME: Nanglegan Beverly Joy Cumahling
Last Name First Name Middle Name
OCCUPATION: Police CONTACT NUMBER: 09060067921
TERMS AND CONDITIONS:
I am aware that the La Consolacion College Manila will create and maintain computerized and hard copy records of my
personal data in the course of my study and after I leave the College. I hereby give my consent that my personal data in
the custody of the College may be used for internal reports and for related student administration to external parties,
within the bounds of the Data Privacy Act of 2012.
NANGLEGAN,JETHRO C. 07/12/2020
Signature over printed name Date signed (MM/DD/YYYY)
NOTE: A signed copy of this Application Form should be submitted together with other pertinent requirements to the Admissions Office when face-to-
face classes resume.