Republic of the Philippines

BICOL STATE COLLEGE OF APPLIED SCIENCES AND TECHNOLOGY

City of Naga
Telephone No. (054) 4720416 Loc. 130

OFFICE OF THE VICE PRESIDENT FOR ACADEMIC AFFAIRS

STUDENT REGISTRATION AND RECORDS OFFICE REGISTRAR’S COPY
REQUEST FOR RETURN FROM LEAVE OF ABSENCE (LOA)
Name: __________________________________________________________ Student No.: ___________________

Degree Program: College:

Granted Leave of Absence (LOA) from: To resume studies in the College starting:
___________ Semester(s), A/Y 20___ - 20 ___ until
___________ Semester(s), A/Y 20____ - 20____
___________ Semester(s), A/Y 20___ - 20 ___
Note: Student is required to submit Medical Clearance from the school clinic if the student availed LOA due to illness.

________________________________
Student’s Signature
Noted by:
_______________________________ ________________________________
College Dean College Registrar III
BISCAST-F-SRR-41
April 2018 Rev. 0 Page 1 of 1
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Republic of the Philippines
BICOL STATE COLLEGE OF APPLIED SCIENCES AND TECHNOLOGY
City of Naga
Telephone No. (054) 4720416 Loc. 130

OFFICE OF THE VICE PRESIDENT FOR ACADEMIC AFFAIRS

STUDENT REGISTRATION AND RECORDS OFFICE DEAN’S COPY
REQUEST FOR RETURN FROM LEAVE OF ABSENCE (LOA)
Name: __________________________________________________________ Student No.: ___________________

Degree Program: College:

Granted Leave of Absence (LOA) from: To resume studies in the College starting:
___________ Semester(s), A/Y 20___ - 20 ___ until
___________ Semester(s), A/Y 20____ - 20____
___________ Semester(s), A/Y 20___ - 20 ___
Note: Student is required to submit Medical Clearance from the school clinic if the student availed LOA due to illness.

________________________________
Student’s Signature
Noted by:
_______________________________ ________________________________
College Dean College Registrar III
BISCAST-F-SRR-41
April 2018 Rev. 0 Page 1 of 1
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Republic of the Philippines
BICOL STATE COLLEGE OF APPLIED SCIENCES AND TECHNOLOGY
City of Naga
Telephone No. (054) 4720416 Loc. 130

OFFICE OF THE VICE PRESIDENT FOR ACADEMIC AFFAIRS

STUDENT REGISTRATION AND RECORDS OFFICE STUDENT’S COPY
REQUEST FOR RETURN FROM LEAVE OF ABSENCE (LOA)
Name: __________________________________________________________ Student No.: ___________________

Degree Program: College:

Granted Leave of Absence (LOA) from: To resume studies in the College starting:
___________ Semester(s), A/Y 20___ - 20 ___ until
___________ Semester(s), A/Y 20____ - 20____
___________ Semester(s), A/Y 20___ - 20 ___
Note: Student is required to submit Medical Clearance from the school clinic if the student availed LOA due to illness.

________________________________
Student’s Signature
Noted by:
_______________________________ ________________________________
College Dean College Registrar III
BISCAST-F-SRR-41
April 2018 Rev. 0 Page 1 of 1