University of Science & Technology of Southern Philippines

Admission and Scholarship Office

PROMISSORY

I______________, an applicant of ________________ hereby promise to

( name) State the department /course applied
submit the indicated document/s as soon as my access would permit.

Please check what applies:

_______ Report Card/Form 138/Certificate of Grades

_______ School ID
_______ 2x2 Photo
_______ Birth Certificate

I further understand that failure to comply with the requirements as promised or

delaying my submission (for reasons of fraud/ incompetence) will make my
application void and that my signature is an expression of my personal consent to
the terms and conditions aforementioned.

_________________________________
PRINTED NAME OVER SIGNATURE

DATE: