Reference No.: BatStateU-FO-REG-11 Effectivity Date: January 3, 2017 Revision No.

: 00

REQUEST SLIP FORM

NAME OF STUDENT: Castillo, Cristine Joy N.
PROGRAM: BS Civil Engineering YEAR GRADUATED:
DATE OF FILING: July 23, 2020 CLAIM DATE:
OR NO. CONTACT NO. 09675502754/ 09122716460

RECORDS REQUESTED

DIPLOMA P 400.00
HONORABLE DISMISSAL P 100.00
FORM 137 P 100.00
CERTIFICATION P 30.00
TRANSCRIPT OF RECORDS P 50.00/Page
/
AUTHENTICATION P 20.00/Page
SECOND COPY OF REGISTRATION FORM P 15.00
GRADUATION FEE (DEGREE)
GRADUATION FEE (NON-DEGREE)
OTHERS, SPECIFY
PURPOSES:

CASTILLO, CRISTINE JOY N.

Signature over Printed Name of Student Signature of Registrar’s Staff

CLAIM SLIP

NAME OF STUDENT: Castillo, Cristine Joy N.

PROGRAM: BS Civil Engineering YEAR GRADUATED:
DATE OF FILING: July 20, 2020 CLAIM DATE:
REMINDERS: CONTACT NOS.
⮚ In claiming a document through a 980-0385 LOC 1849/1933 (REGISTRAR MAIN I)
representative,Authorization letter and valid IDs of 425-0139 LOC 2149 (REGISTRAR MAIN II)
Claimants are required. 416-0349 LOC 114 (ARASOF CAMPUS)
⮚ Provide Documentary Stamp for each copy of 778-2170 LOC 110 (MALVAR CAMPUS)
requested documents EXCEPT for authentication.

SIGNATURE OF REGISTRAR’S STAFF