Republic of the Philippines

Department of Education
Region IX, Zamboanga Peninsula
Division of Zamboanga City
Baliwasan District
SAN JOSE GUSU ELEMENTARY SCHOOL
Zamboanga City
email us at sanjosegusu_es@yahoo.com
tel. no. (062) 983-1409

REGISTRATION FORM
School Year___________
Grade Level:_________

Please Mark (/)

New Student Old Student Balik-Aral Repeater Transferee

Name:_________________________________________________________________________________________
Family Name First Name Middle Name
Home Address: __________________________________________________________________________________
Date of Birth:______________Place of Birth:______________________Tribe:______________Religion:___________
Parents:
Father:__________________________________________Occupation:____________________________
Mother’s Maiden Name :____________________________Occupation:___________________________
Contact Number:___________________________ Height:___________Weight:_________Sex:______
Indigenous People: Yes No (If yes please specify)_____________________
Guardian (If not staying staying with parents):___________________________________________
Address:________________________________________________________________________
Contact Number:___________________________

SCHOOL DISCIPLINE
The school shall maintain discipline inside the school campus as well as outside the school premises when
students are engaged in activities authorized by the school (DECS ORDER No. 92,S. 1992).
School officials and teachers shall have the right to impose appropriate reasonable disciplinary measures in case
of minor offenses or infraction of good discipline. Hereunder are offenses punishable by suspension or expulsion
depending on the seriousness of the offense (Sections 1.1.2, Part IV, Chapter 3, DECS Service Manual 2000 p.88)
1. Gross misconduct
2. Cheating and stealing
3. Assaulting a teacher or any school authority or his agents or students
4. Smoking inside the school premises
5. Vandalism, writing on or destroying school property like chairs,tables,windows,books,laboratory equipment and
others.
6. Gambling of any sort
7. Drinking intoxicants or liquor
8. Carrying and concealing deadly weapons
9. Extortion or asking money from others
10. Fighting, causing injuries to others
11. Using, possessing and selling of prohibited drugs
12. Hazing in any form or manner whether inside or outside the school premises
13. Immorality or sexual harassment
14. Instigating, leading or participating in concerting activities leading to stoppage of classes
15. Preventing, threatening students or faculty members or school authorities from discharging their duties or from
attending classes or entering school premises
16. Forging or tampering with school records or transfer forms

In witness thereof, I hereby agree to abide by the school policies, rules, regulation, prohibition, ect. And to
accept the punishment /penalty for any violation or infraction thereof and to replace or pay any loss/damaged
books, school and government properties through his/her own neglect or misuse.

Conformed:

_____________________________
Parent’s Signature Over Printed Name

Witness:

______________________________ ANNA LIZA DZ. MARTIN

In-charge of Registration ES Principal I