GS Form No.

3B

University of the Philippines Los Baños

College, Laguna 4031

ACCEPTANCE/DEFERMENT CARD

Student’s Name :
Term of Admission :
Degree Program :
Admission Status :
Please let us know as soon as possible if you wish to accept this admission. Check
the appropriate box below and send to UPLB Graduate School through mail or as
email attachment on or before your pre-enrollment medical exam.
Accept Admission
Defer* Admission
Reason (s) for deferment:

I will enroll: 1st Semester 2nd Semester

School Year

Deferment Fee: Cash Postal Money Order Amount :

(Mode of Payment)

Student’s Signature Date

Student’s Preferred Mailing Address:

Student’s Email Address :

Mobile No. :

* Deferment period should not exceed one year (2 semesters). Deferment fee of PhP200 for
Filipino citizen or USD15 for foreign nationals will be charged. For students who will hand
carry this card, payment should be made in cash. For students who will mail this card,
payment should be remitted in Postal Money Order to the UPLB Graduate School. Personal
cheques will not be accepted. An approved letter of deferment will be sent to your mailing
address upon receipt of this card and payment. The approved letter of deferment will then be
presented during enrollment.