STUDENT NO.: ______________________ NAME: ___________________________________________________
COURSE: _______________________________________ YEAR LEVEL: __________________________________
SIGNATURE: ____________________________________
I would like to request permission to cross-enroll at __________________________________________
the (term) ______________________________ AY _____________________________ for the following reasons:
____________________________________________________________________________________________
____________________________________________________________________________________________
No. of Units Registered: ________________ No. of Units Applied for _______________ Total Load: ____________
at home unit as cross registrant
Home Unit Approval: Host Unit Approval:
_________________________________ _________________________________
_________________________________ _________________________________
For cross-registration outside UP System:
_________________________________
_________________________________________________________________________________________________________
(please detach and submit to home unit)
THE REGISTRAR
University of the Philippines Diliman
This is to certify that ____________________________________________________ has been admitted as cross-enrollee this _________________________ Semester/Academic Year _________________________ for ______________ units in the College of ___________________________________________________________ . ______________________________________
* Requirements submitted:
- Medical Certificate
- Adviser's certification re: remaining deficiencies (for graduating student only) - Certificate of scholastic standing from the College Secretary
ACKNOWLEDGEMENT
Signature over printed name Registrar-Host Unit/Accepting School _______________ : _______ : _________________ : ________________ : ______ : _________________ : _______________ : _______ : _________________ : ________________ : ______ : _________________ :
Registrar
VCAA/Chancellor
Registrar Department Chair
UNIVERSITY OF THE PHILIPPINES
Diliman, Quezon City
REQUEST TO CROSS-REGISTER
Subjects Requested : Units : Adviser's Validation : Alternate Subjects : Units : Adviser's Validation :
Dean
_________________________________________________________________________________________________________
_______________ : _______ : _________________ : ________________ : ______ : _________________ : _______________ : _______ : _________________ : ________________ : ______ : _________________ : Subjects Requested : Units : Adviser's Validation : Alternate Subjects : Units : Adviser's Validation :
