DLSU-D DECLARATION FORM
INSTRUCTIONS:
This declaration form must be filled out by the applicant’s School Representative either of
the following:
Class Adviser, Guidance Counselor, School Registrar, or School Principal
After completing the DLSU-D Declaration Form, the student applicant must upload the
form to his /her DLSU-D Admissions Portal.
To the EVALUATOR:
The below–named person is applying for admission at De La Salle University -
Dasmariñas. Please check whichever applies to the student applicant:
He is presently enrolled in your school.
Yes
No What is the last Academic Year attended?
I certify that the applicant is eligible to apply for COLLEGE FRESHMAN for AY 2025-2026
EVALUATOR’S INFORMATION
Name (Last, First, MI) Designation (Please select the
appropriate designation) Class
Adviser / Guidance Counselor / School
Registrar / School Principal
Signature and Date Email Address / School’s Contact No.
******************************************************************************
Applicant’s Name:
GADAYAN , JAMES ERNST ARAGON
Name of School: GEN. MARIANO ALVAREZ TECHNICAL HIGH SCHOOL
School Address:
688 CONGRESSIONAL AVENUE, GMA, CAVITE
I am applying for COLLEGE FRESHMAN.
This is to certify that I have not enrolled in any school/college/university COLLEGE
FRESHMAN before.
This is to certify that the information above is true and correct. I understand that any
misdeclaration and withholding of information employed by me or on my behalf in
relation to this shall be a ground for non-admission or exclusion from DLSU-D.
Signature over printed name of applicant Signature over printed name of parent/guardian
Date:-------------------------------------------