5. NSTP
____ No obligation
______________________________
[Coordinator]
____________________, 20_______
--- 6. ACCOUNTING OFFICE
Back Account……...P ____________
Graduation Fee…….P ____________
Diploma………P ____________
TOR………. P ____________
Yearbook….……… P ____________
Pictorial Fee……… P ____________
Alumni Fee...…… ...P ____________
Alumni Seminar... P ____________
Others ………. P ____________
TOTAL ………….. P ____________
O.R. No.__________ Date: ________
_______________________________
[University Accountant]
____________________, 20_______
---
7. Recommending Approval:__________________
[Program Chair]
_______________________________________________
[College Dean]
______________________. 20 ________
_____
____________________,_______
==============================================================================
Approved by:
___________________________________
[Vice Chancellor for Academics, Research, and Mission]
____________________, 20_______
INSTRUCTIONS:
1. Please prepare this form in five [5] copies for Graduate and [4] copies for Undergraduate.
2. Secure all necessary signatures and/or initials.
3. Please submit one copy each to the following offices: Registrar’s Office, Accounting Office, Alumni Office and Office of Student Services and Organizations.
4. Always keep one copy which you will present to the Office of the University Registrar each time you transact business requiring clearance.
Victoneta Avenue, Malabon City
STUDENT CLEARANCE
DOCUMENT APPLIED FOR No. _________
[Please check]
_____ Diploma _____ TOR
_____ Transfer Credentials
_____ Others [please specify] ___________________, 20___
NOTE: It is understood that any “0.0” grade incurred by the student applicant before the issuance of his/her transfer credentials can no longer be changed even if the grace period has not yet lapsed.
NAME: ________________________________________ Course:___________________
[Family] [Given] [M.I.] Student I.D. No.:__________________
First enrollment in the
University ________________________________________________________________________
[Term] [Academic Year] [College]
Last enrollment in the
University ________________________________________________________________________
[Term] [Academic Year] [College]
