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Republic of the Philippines

SOUTHERN LEYTE STATE UNIVERSITY


San Isidro, Tomas Oppus, Southern Leyte,
Philippines website:
http://www.slsuonline.edu.ph
email: slsu_tomas_oppus@yahoo.com telefax:
053-577-8299

WAIVER TO ENROLL SUBJECTS WITH


[ ] CURRENTLY ENROLLED PRE-REQUISITE SUBJECT/S
[x] NO GRADE IN PRE-REQUISITE SUBJECT/S

Date: August 13, 2021

I, Shiello Juanico, a Bachelor of Secondary Education major in Science student of this


University, hereby declare that I am going to enroll the [] requested subject [x] offered
subject / s ITC-AD 201, Maj-Sci 203L, Maj-Sci 203, PE 201 for this 1st semester, AY 2021
2022.

If in case I cannot obtain a passing grade of the pre-requisite subject/s enrolled, my


enrollment of the higher subject/s will become null and void. Thus, I do not hold any faculty
and officials of the University for any unfavorable circumstances I may experience related to
this concern.

Pre-Requisite Subject/s with No Grade Pre-Requisite Subject/s Enrolled Subject/s with Pre-Requisite (Enrolled)
GE-Eng 101_____________________ __________________________________ ITC-AD 201______________________
Maj-Sci 101L________ ___________ __________________________________ Maj-Sci 203L____________ ________
Maj-Sci 101_____________________ __________________________________ Maj-Sci 203______________________
Maj-Sci 104_____________________ __________________________________ PE 201____________________ ______

Parent(s) / Guardian Consent


____________________________________________ ____________________________________________
Signature over Printed Name Signature of Student
Academic Adviser’s Consent

____________________________________________
Academic Adviser / Date

Approved:

____________________________________________
Dean/ Department Head / Date

Noted:
____________________________________________
University Registrar / Date

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