CATHOLIC EDUCATIONAL ASSOCIATION OF THE PHILIPPINES

ANNUAL MEMBERSHIP DUES ASSESSMENT FORM

FOR THE SCHOOL YEAR :

SCHOOL : REGION :
ADDRESS : ZIPCODE :

I. ANNUAL MEMBERSHIP COMPUTATION FOR BASIC EDUCATION:

PREVIOUS SY PREVIOUS SY
MONTHLY TUITION FEE * ENROLLMENT (No. of Students) AMOUNT

A. PRE-ELEMENTARY
Nursery Php x 0.01 x = Php -
Kinder 1 (Jr.) Php x 0.01 x = Php -
Kinder 2 (Sr.) Php x 0.01 x = Php -
Prep Php x 0.01 x = Php -
Sub-total Php -
Amount Due Ceiling ** 16,500.00 Php -

B. ELEMENTARY
Grade 1 Php x 0.01 x = Php -
Grade 2 Php x 0.01 x = Php -
Grade 3 Php x 0.01 x = Php -
Grade 4 Php x 0.01 x = Php -
Grade 5 Php x 0.01 x = Php -
Grade 6 Php x 0.01 x = Php -
Sub-total Php -
Amount Due Ceiling ** 16,500.00 Php -

C. JUNIOR HIGH SCHOOL

Grade 7 Php x 0.01 x = Php -
Grade 8 Php x 0.01 x = Php -
Grade 9 Php x 0.01 x = Php -
Grade 10 Php x 0.01 x = Php -
Sub-total Php -
Amount Due Ceiling ** 16,500.00 Php -

D. SENIOR HIGH SCHOOL

Grade 11 Php x 0.01 x = Php -
Grade 12 Php x 0.01 x = Php -
Sub-total Php -
Amount Due Ceiling ** 16,500.00 Php -

II. ANNUAL MEMBERSHIP COMPUTATION FOR COLLEGE & GRADUATE SCHOOL LEVELS:
PREVIOUS SY PREVIOUS SY
UNIT TUITION FEE *** ENROLLMENT (No. of Students)
A. COLLEGE
Degree Php x 3 units x 0.01 x = Php -
Non Degree Php x 3 units x 0.01 x = Php -
Sub-total Php -
Amount Due Ceiling ** 33,000.00 Php -
B. GRADUATE SCHOOL
Degree Php x 3 units x 0.01 x = Php -
Non Degree Php x 3 units x 0.01 x = Php -
Sub-total Php -
Amount Due Ceiling ** 33,000.00 Php -

TOTAL MEMBERSHIP DUES -

III. SUBSCRIPTION FOR SCHOOL HEAD'S OFFICE:

A. CEAP Bulletin (Php 400/year, including mailing) Php 400.00
B. CEAP Directory (Php 400/year, including mailing) Php 400.00
Sub-total Php 800.00

GRAND TOTAL 800.00

* If Annual Tuition Fee divide by 10 months.
** If the total computed membership dues per level/dept. is higher than the ceiling set, please pay only the Ceiling amount.
*** If the deparment has varying unit tuition fee rates among courses offered.

SUBMITTED BY:

Signature over printed name

Designation

MODE OF PAYMENT: Date

CHECK NO. Php
PMO NO. Php
CASH Php