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Re Transfer Credentials

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Shenellyn Pineda
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127 views1 page

Re Transfer Credentials

Uploaded by

Shenellyn Pineda
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Form No.

RE-13-202008
FOR OUR USE ONLY

RECEIVED BY RELEASED BY

APPLICATION FOR TRANSFER CREDENTIALS

PLEASE PRINT
AY/TERM DATE RECEIVED DATE DUE
PERSONAL INFORMATION ACADEMIC INFORMATION
LAST NAME ID NUMBER
FIRST NAME COURSE/
MIDDLE NAME DEGREE
MAIDEN NAME CAMPUS ❑ Manila ❑ Laguna ❑ BGC
CONTACT INFORMATION TYPE OF PROCESSING
EMAIL ❑ Regular ❑ Express
STATUS REMINDERS
Have you ever filed for a Did you graduate from 1. For students currently enrolled, this application
Transfer Credential DLSU? will result in entries of failing grades in the
(Honorable Dismissal) Transcript of Records if filed after Week 7 of the
❑ Yes, I graduated on term.
from DLSU?
________________ 2. Signature of parent/guardian is required for
❑ No DATE undergraduate students below 18 years old. Photocopy
❑ No, I last attended of valid ID (with signature) of parent/guardian must
❑ Yes accompany this form.
DLSU on AY ___ - 3. For graduate students, accomplish clearance for the
___ Term ___ offices/units on the right column only.
CONFORME
❑ I understand that if I apply for Transfer Credentials, I will be classified as a Transferred Student.
I understand that I may no longer apply for re-admission at De La Salle University.
❑ I understand that this Application for Transfer Credentials, if and when approved, is a permanent
termination of studies at De La Salle University, and may not be cancelled any time.
SIGNATURE OF STUDENT SIGNATURE OF PARENT/GUARDIAN

SIGNATURE OVER PRINTED NAME/DATE SIGNATURE OVER PRINTED NAME/DATE


CLEARANCE
(SIGNATURE OVER PRINTED NAME/DATE)
OFFICE OF ADMISSIONS AND SCHOLARSHIP (2ND FLOOR HSSH) LIBRARY

PE DEPARTMENT (7TH FLOOR, E. RAZON SPORTS COMPLEX) STUDENT DISCIPLINE FORMATION OFFICE (J105)

OFFICE FOR COUNSELING AND CAREER SERVICES STUDENT ACCOUNTS (ACCOUNTING OFFICE, LS GROUND FLOOR)
(2ND FLOOR, BRO.CONNON HALL)

COMPUTER LABORATORY DEPARTMENT CHAIR/PROGRAM COORDINATOR

SCIENCE/ENGINEERING LABORATORY DEAN/VICE DEAN

ROTC (2ND FLOOR WAREHOUSE) / (STRC COMPOUND)

(FOR UNDERGRADUATE ONLY) DO NOT FILL (FOR OUR USE ONLY)


HIGH SCHOOL HS TOR ENROLLMENT (UG/GS)
WHERE GRADUATED
IMPORTANT: PLEASE RETURN THIS FORM TO THE ENROLLMENT SERVICES HUB UPON Amount ……………………
PAYMENT TO THE ACCOUNTING OFFICE. THANK YOU.
WILL NOT BE PROCESSED WITHOUT MACHINE VALIDATION OF PAYMENT Add: Delivery Charges ….

Total ………………………

ALL RIGHTS RESERVED. Parts of this material may be reproduced provided (1) the material is not altered; (2) the use is non-
commercial; (3) De La Salle University is acknowledged as source; and (4) DLSU is notified through [email protected]

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