MANILA, PHILIPPINES

Student Name:
Last Name First Name Middle Name
Student No.: Program/Year: Contact Number(s)
Candidate on: Programmed Study Load:
Quarter, Quarter, Quarter,
COURSES UNITS COURSES UNITS COURSES UNITS

Total: Total: Total:

Total Units Remaining:

(if with waiver)
PREREQUISITE COURSE(S) GRADE & STATUS ADVANCED COURSE(S)

PREREQUISITE AND ADVANCED COURSES TAKEN SIMULTANEOUSLY

I wish to take the above listed prerequisite and advanced courses simultaneously.
I fully understand that should I fail the prerequisite course listed above, I will not receive any credit for the
corresponding advance course in conformity with the MAPA RULES AND REGULATIONS.

REQUEST FOR STUDY OVERLOAD

I attest to the fact that I have no more than thirty four (34) units left for me to qualify for graduation.
However, in the event that records of the Registrars Office indicate otherwise, I hereby authorize and do
hereby agree that the Registrars Office Program Section Chief shall drop course(s) from my student load for
this quarterm to comply with the Institutes policy on the maximum number of units a student is allowed to
take in a particular quarterm.

Signature of Student Over Printed Name

Verified by: Recommending Approval: Approved:

Program Section Chief DEAN Registrar

RO-019-02