Online Registration (College Student)

Central Luzon Doctors' Hospital Educational Institution, Inc. recognizes the right to privacy and aims to comply with the requirements of the Data Privacy Act of 2012 with respect to the data they collect or acquire from the Enrollee.

The personal data obtained from this form is entered and stored within the College’s authorized Information and Communications System and will only be accessed by authorized school personnel. Central Luzon Doctors' Hospital Educational Institution, Inc. has instituted appropriate organizational, technical, and physical security measures to ensure the protection of the Enrollee's personal data.

By answering this form, I give my consent to Central Luzon Doctors' Hospital Educational Institution, Inc that they may collect, use, disclose and process my personal data for the purposes of, but not limited to, application for admission or enrollment.

I Agree to the Flexible Learning Method *

Please be advised that A.Y. 2021-2022 will be delivered using FLEXIBLE LEARNING METHOD.

Upload Colored Picture with White Background *

Student's Information

First Name *

Middle Name

Last Name *

Suffix Name

Address *

Contact Details

Mobile Number *

Landline Number

Email Address *

Application

Enrollee Type *

Student ID Number (format: 00-0000-000) *

School Last Attended *

Last Year Level Completed *

Last School Year Attended *

Last STRAND *

Course *

Year Level *

School Year

Semester

Parents / Guardian's Information

Father's Full Name

Father's Contact Number

Father's Email Address

Father's Occupation

Father's Name of Company

Father's Company Address

Mother's Full Name

Mother's Contact Number

Mother's Email Address

Mother's Occupation

Mother's Name of Company

Mother's Company Address

Guardian's Full Name

Guardian's Contact Number

Guardian's Email Address

Guardian's Occupation

Guardian's Name of Company

Guardian's Company Address

Old Student Requirements - (Photo Copy, PDF Only)

Last School ID (Photo Copy) *

Clearance Form (PDF only) *

Transferee Student Requirements - (PDF only)

Honorable Dismissal (PDF only) *

Copy of Grades (PDF only) *

PSA Birth Certificate (PDF only) *

Certificate of Good Moral Character (PDF only) *

Incoming First Year Student Requirements - (PDF only)

Copy of Grades / Form 138 (PDF only) *

PSA Birth Certificate (PDF only) *

Certificate of Good Moral Character (PDF only) *

I agree to the Data Privacy Agreement *

I hereby certify that the above information given are true and correct to the best of my knowledge and I allow CLDHEI to use my son/daughter details to create and/or upgrade student profile in the School Information System. The information herein shall be treated as confidential in compliance with the Data Privacy Act of 2012

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