Glan Institute of Technology

for Academic Year 2025-2026 Enrollment

Please complete the form below

Email Address: *

New/Transferee: *

Department: *

Program: *

Basic Information

First Name: *

Middle Name:

Last Name: *

Suffix:

Put Suffix after First Name

Facebook Name:

Facebook Link:

Birthdate: *

Civil Status: *

Gender: *

Religion: *

Ethnicity: *

Nationality: *

Personal Contact Number: *

Birth Place:

Street (i.e., Lot. No., Block No., Purok, Barangay): *

Province: *

City/Municipality: *

Permanent Address:

Street (i.e., Lot. No., Block No., Purok, Barangay): *

Province: *

City/Municipality: *

Is permanent address same with home address?

Home Address:

Street (i.e., Lot. No., Block No., Purok, Barangay): *

Province: *

City/Municipality: *

Education

LRN:

Last school attended during Elementary: *

Year Graduated: *

Last school attended during High School: *

Year Graduated: *

Last school attended during Senior High School: *

Year Graduated: *

Strand: *

Last school attended during College: *

Program: *

Year Graduated: *

Father's Information

Father's Name: *

Occupation: *

Contact Number: *

Educational Attainment: *

Mother's Information

Mother's Name: *

Occupation: *

Contact Number: *

Educational Attainment: *

Guardian's Information (If you live with your parents, enter your father's details here. Otherwise, enter the details of your current co-resident.)

Same as Father's Information

Guardian's Name: *

Occupation: *

Contact Number: *

Relationship to Guardian: *

Current Address: *

Parents’ Joined Estimated Annual Income (in Peso): *

Data Privacy Consent

The Glan Institute of Technology will collect, store, and process your Personal Information such as but not limited to, full name, birth date, address, parent’s information, tribe, and religion. The school will disclose your Personal Information upon the request of the Department of Education, Commission on Higher Education, and other government agencies which may require the school to provide such as the court of law in aid for any judicial proceedings, if applicable. Do you allow the school to collect, store, and process your data?

I acknowledge that I have read and fully understand the data privacy consent. I allow and hereby attest that the information I have entered is true and correct to the best of my knowledge. *

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Program

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Personal

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Guardian

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Done

Glan Institute of Technology

for Academic Year 2025-2026 Enrollment

Please complete the form below

Submission Successful!

Bring and submit the following requirements to the Records Office:

📘 Freshmen (College)

📘 Transferees (College)