REFUND FORM

DOCUMENTS TO BE ATTACHED:
Student's Name: 1. Original Certificate of Registration (COR)
Trisha May Ang

Student's ID No.: 201911128 Contact No.: 09777514601 2. Original Official Receipt/s (OR)
3. Other documents (i.e.cancellation form, scholarship
approval, load revision etc.)
I hereby acknowledge that I have acquired the consent from all parties relevant to this activity and that they allow FEU Institute of
Technology to collect, process, store, and share their personal data and hold free and harmless and indemnify FEU Institute of
Technology from any complaint, suit, or damages which any party may file
Course: BSEE
Student's Signature: Date: 09/25/2020

TO BE ACOMPLISHED BY THE ACCOUNTING OFFICE

Refund Computation:

Total amount for refund: P

Amount in words:
Reason for Refund
Overpayment 5% ca sh discount Other reason/s (pleas e specify):
Cancellation of enrollment Dropping of subjects
Approved scholarship Petitio n of subjects
Check Payable to Student and Parent/Guardian Enrollment and/or Scholarship Validated by:
Parent/Guardian:
Relationship: Registrar
Mobile No.: Signature Over Printed Name/Date
Prepared by: Recommended by: Approved by:

Accounting Assistant Senior Director for Finance Executive Director

Date: Date: Date:

FO-FIN-ACC-001/09OCT2019/REV1