Republic of the Philippines

Cebu Normal University

Osmeña Blvd. Cebu City, 6000 Philippines

University Registrar
Telephone No.: (+63 32) 254 0067; 254 1452 local 134
Email: registrar@cnu.edu.ph
Website: www.cnu.edu.ph

REQUEST FOR SCHOLASTIC RECORDS

NOTE: A WRITTEN AUTHORIZATION FROM THE OWNER MUST BE PRESENTED IF REQUEST IS TRANSACTED BY A
REPRESENTATIVE TOGETHER WITH VALID IDs OF GRANTOR OR OWNER AND THE AUTHORIZED
REPRESENTATIVE.
Please filled-up information below legibly. To be accomplished by the Registrar Personnel only.
Date Filed: ________________ PAYMENTS FOR THE REQUESTED
Name: _____________________________________ DOCUMENT/S:
Maiden Name if Married: ______________________ Cert. of Transfer Credential
Contact No._______________ Transcript of Records
Present Address: _____________________________ Certification
___________________________________________
v Diploma
Course: ____________________________________
If graduated, please specify year: _______________ COP
Authentication
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Please check the box for the request/s & purpose. A
Documentary Stamp
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Others: ________________
REQUEST FOR: r
TOTAL:
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Certificate of Transfer Eligibility/Honorable Dismissal t
O.P.#
: Pls. specify the degree: _______________ t
O.R. No.
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Date:
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A
Assessed by: _____________________________
u (Receiving Window)
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Cleared
h by: _______________________________
o Accountant/Authorized Representative
PURPOSE:
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Personal File i
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Claiming Section Only
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______________________ t
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__________________________________ n
Signature Over Printed Name of Student i
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_____________________________________ r
Signature Over Printed Name of Representative e
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Follow this very important instructions. u
1. Fill-up this form and submit for assessment to the assisting Registrar Personnel.
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2. Present the assessed form to the Cashier for Order of Payment, Clearance and Payment.
3. Pay the amount assessed. r
4. Proceed to the Library for Clearance. e
d Registrar’s Office for stamping of the claiming date by the
5. Submit this form with the Official Receipt of payment back to the
processor. i
6. Claim the document(s) on the date indicated at the back of the fOfficial Receipt.
SDF-URO-105-006-00
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