Republic of the Philippines

PALAWAN STATE UNIVERSITY

College of Engineering Architecture and Technology
Puerto Princesa City

APPLICATION FOR GRADUATION

for May 2020

Department of Civil Engineering

Name: Patrick Steven Ancheta Gonzales

Permanent Address: Purok Maunlad, Barangay Irawan. Puerto Princesa City, Palawan
City Address: Purok Maunlad, Barangay Irawan. Puerto Princesa City, Palawan
Date of Birth: August 15, 1999
Name of Father: Junny M. Gonzales
Occupation: Driver
Name of Mother: Gloria A. Gonzales
Occupation: Business Woman
Mobile number: 09283697730

Course Name of School Attended School Year

Elementary:
Primary (Gr 1- Gr IV) Puerto Princesa Pilot Elementary 2005-2009
School
Intermediate (Gr V- VI) Puerto Princesa Pilot Elementary 2009-2011
School
High School:
First Year Palawan State University- Laboratory 2011-2012
High School
Second Year Palawan State University- Laboratory 2012-2013
High School
Third Year Palawan State University- Laboratory 2013-2014
High School
Fourth Year Palawan State University- Laboratory 2014-2015
High School
College:
First Year Palawan State University – Main 2015-2016
Campus
Second Year Palawan State University – Main 2016-2017
Campus
Third Year Palawan State University – Main 2017-2018
Campus
Fourth Year Palawan State University – Main 2018-2019
Campus
Fifth Year Palawan State University – Main 2019-2020
Campus

Subject Enrolled Now Unit Time Days Room Instructor

1st Sem 2016-17

2nd Sem 2016-17 Unit Time Days Room Instructor

Subjects to be completed/ removed Semester and SY Taken Instructor

 Republic of the Philippines
PALAWAN STAE UNIVERSITY
College of Engineering Architecture and Technology
Puerto Princesa City

APPLICATION FOR GRADUATION

PROF. MARISSA S. PONTILLAS

OIC- University President
This University

Through: The Civil Engineering Department Chairperson

Sir:

I have the honor to apply for graduation for the five-years curriculums leading to a degree of Bachelor of Science
in Civil Engineering this __________ Semester of SY _____________. The following are the subjects have taken
with the corresponding grades and unit credits.

I. Academic Requirements
Subjects Grades Credits Semester Where Taken

A. English

____ENG 1___________ _______ ___3____ ___1st____ _________________

____ENG 2___________ _______ ___3____ ___2nd ___ _________________

B. Filipino
____FIL 1____________ _______ ___3____ ___1st____ _________________
____FIL 2____________ _______ ___3____ ___2nd ___ _________________

C. Social Sciences
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________

D. Mathematics

____MATH 1________ _______ ___3____ ___1st____ _________________

___________ _______ ___3____ ___1st____ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________

E. Physical Sciences
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________

F. Basic Engineering Sciences

___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________

G. Physical Education

____PE 1___________ _______ ___2____ ___1st____ _________________

____PE 2___________ _______ ___2____ ___2nd ___ _________________
____PE 3___________ _______ ___2____ ___1st____ _________________
____PE 4___________ _______ ___2____ ___2nd ___ _________________
___________________ _______ ________ _________ _________________

H. ROTC/CWTS

_CWTS I / ROTC 1__ _______ ___3____ __1st_____ _________________

_CWTS II / ROTC 2__ _______ ___3____ __2nd ____ _________________

I. Professional and Allied Courses

___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ _______ ________ _________ _________________
___________________ ________ ________ _________ _________________

II. Summary of Deficiencies

a. Academic Requirements
_______________________ ___________________ _________________
_______________________ ___________________ _________________
_______________________ ___________________ _________________

b. Admission Requirements

______________Form 137-A _________________Birth Certificate

______________Transcript of Records
I hereby CERTIFY that the above are true and correct.

Signature over Printed Name of Applicant

III. Recommendations/Comments /Action

___
_________________________________________________________________________________
________________________________________________________________________

Checked by: ALLAN JAY L. JAVIER

College Secretary

Recommending Approval: Approved by:

_JENNIFER C. CACAL__ ELUCILA M. SESPEÑE

Chairperson Dean
College of Engineering Architecture and Technology

Registrar