STUDENT CLEARANCE FORM

FOR STUDENT USE

Student Name: Harry Mathew C. Severino Course:Accountancy Major: Accounting
Home Address:Brgy74 Balintong Drive NulaTula, Term & Year Graduated: 2nd sem 2020
Tac. City, Leyte
Telephone: - Mobile:09455779810 Email: faceless2893@gmail.com
Note to the student:
Upon completion of your course, you must obtain a signature from your departments indicated below for
clearing of all your obligations in School. It is the responsibility of the student to check with the SPSPS
Departments listed and to obtain a final clearance before leaving Saint Paul School of Professional Studies .
FOR OFFICIAL USE
Librarian:
It is confirmed that the student has no obligations regarding borrowed books and other library resources.

Name: Signature Date: / /

Student Personnel Services Office:
It is confirmed that nothing is pending against the mentioned student.

Name: Signature Date: / /

School Accountant:
It is confirmed that all financial obligations of the student has been settled.

Name: Signature Date: / /

Subject/s and Professor/s during the terminal semester:
Professor’s Signature and Professor’s Signature and
Subjects Subjects
Student’s Grade Student’s Grade
APROREV Ma’am Malquisto / LP SNTHSIS Sir Baldevia / 1.4
ATEOREV Sir Malquisto /Passed TAXNREV Sir Chan / LP
AUDAPP2 Ma’am Romanca / 1.8
INTAUD1 Sir Resula / 1.6
MANSREV Ma’am Rocabo / LP
Department Chair:
It is confirmed with the faculty that the student passed in all subjects taken during the terminal semester.

Name: Signature Date: / /

Dean:
It is confirmed that the student has completed all academic requirements for his/her course.

Name: Signature Date: / /

Registrar:
It is confirmed that the mentioned student has submitted all the necessary documents required for graduation

Name: Signature Date: / /

TO BE ACCOMPLISHED BY THE STUDENT UPON RECEIPT OF CREDENTIALS OF SPSPS.
Student Pledge:
It is confirmed that I received all the official/original documents (diploma, transcript & certificates) from SPSPS.

Name: Signature Date: / /

NOTE:
1. Accomplish this form in two (2) copies.
2. The completed form must be returned to the Office of the Registrar.