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NAME: _______________________________________________________________ SCHOOL: _____________________________________________________________ CELLPHONE NO.

: _____________________ EMAIL : ________________________ Proposed Tuition Increase: Current Tuition Fee (per unit): Proposed Tuition Fee (per unit):

Proposed Miscellaneous and Other Fee Increases: Current Fee/s Proposed Fee/s

Please encircle ✓

✓if the statement applies to your school. Otherwise encircle

A consultation was conducted by the school regarding their intention to increase tuition and other fees. Consultations occurred on or before Feb 28, the deadline of tuition consultations. If applicable, when and where did the consultation occur? ____________________________________________ Notices to parties (i.e., the student council) about proposed tuition increase was sent 15 days before the actual consultations. When did the student council receive such notice? _________________

Notices about proposed tuition increase were posted in conspicuous places 15 days before consultation date. The consultation was an actual meeting and/or discussion. The advantages and disadvantages of the proposed tuition and other school fees were discussed in the consultation. The participants of the consultation had the opportunity to air their sentiments without fear, and under a free and candid atmosphere.

✓ ✓

The consultation was attended by the following: ✓ The Student Council/Government or in the absence of such, representatives from student organizations. Please include names of student attendees and their position in the student council or student organization if possible: ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ✓ ✓ ✓ ✓ Faculty Alumni Non-teaching personnel association The consultation included the discussion of proposed increases in miscellaneous and other fees. The sectors were given the following information for consideration before the consultation: ✓ ✓ ✓ ✓ Current fees rate Proposed fee increase expressed in both peso and percentage terms Duration and justification on the charging of fees Latest audited financial statements (as requested by authorized parties) The above information was provided by the school ____ days prior to the consultation.

In the school's proposal: ✓ 70 percent of the proceeds of the proposed tuition increase shall be used for the payment increase of salaries, wages, allowances and other benefits of the school's teaching and non-teaching personnel and other staff, except for administrators who are principal stockholders of the school ✓ At least 20 percent of the proceeds of the proposed tuition increase shall be used for the improvement or modernization of buildings, equipment, libraries, laboratories, gymnasia and other similar facilities ✓ Only 10 percent (or less) of the proceeds of the proposed tuition increase shall be for the return of investment of stockholders What are the sectors’ responses to the proposed fees increases (YES/NO): ________ Student Council / Government, or in the absence of such, representatives from student organizations. ________ Faculty ________ Alumni ________ Non-teaching personnel association Was there a counter-proposal by any of the sectors? If yes, please indicate: ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ I hereby certify that the statements and information in this application form are true and correct to the best of my knowledge and belief. Name of Respondent: ____________________________________________________ Organization/Position: ____________________________________________________ Signature: _____________________________________________________________