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Application For Evaluation of Academic Credits (For Undergraduate Students)

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Stephen Velasco Villaruz
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36 views2 pages

Application For Evaluation of Academic Credits (For Undergraduate Students)

as

Uploaded by

Stephen Velasco Villaruz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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FORM 1 REG-ES-MAR2017

Office of the Registrar

APPLICATION FOR EVALUATION


Instructions:
1. This form is NOT AN APPLICATION FOR GRADUATION but an application for evaluation of academic credits.
2. Fill out this form and file at the Evaluation Section (Office of the Registrar) according to the schedule
announced in the bulletin boards.
3. Distribution of evaluation results thru DEFICIENCY FORM shall be announced before enrollment period of
the proceeding semester/term.
***************************************************************************************

ID #________________Name: __________________________________________________________________
(Family Name) (First Name) (Middle Name)

Sex: __________________ Name of Father: _____________________________________


Civil Status: __________________ Name of Mother: ____________________________________
Citizenship: __________________ Home Address: Street # _______________________________
Date of Birth: _________________ Town/City ______________________________
Place of Birth: _________________ Province _____________________________
Religion: _________________ Contact # _____________________________

EDUCATIONAL ATTAINMENT

Level of Education Name of School Year Completed


Elementary: _________________________________________________________________________ _____________

Secondary: _________________________________________________________________________ _____________

Expected Date of Graduation: _____________


Academic Program (e.g. Bachelor of Science/Arts in..): ___________________________________________________
Major: ______________________

PRESENT LOAD
Subjects Units Time Days Room No. Teacher
1. ______________ ________ __________ ____________ _____________ ______________________
2. ______________ ________ __________ ____________ _____________ ______________________
3. ______________ ________ __________ ____________ _____________ ______________________
4. ______________ ________ __________ ____________ _____________ ______________________
5. ______________ ________ __________ ____________ _____________ ______________________
6. ______________ ________ __________ ____________ _____________ ______________________
7. ______________ ________ __________ ____________ _____________ ______________________
8. ______________ ________ __________ ____________ _____________ ______________________
9. ______________ ________ __________ ____________ _____________ ______________________
10. _____________ ________ __________ ____________ _____________ ______________________
11. _____________ ________ __________ ____________ _____________ ______________________
12. _____________ ________ __________ ____________ _____________ ______________________
Total Units ________

I hereby certify that the foregoing entries are true and correct to the best of my knowledge.

Deadline for filing: _________________ _____________________


Date submitted: _________________ Signature

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