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Place a comma ( , ) between last and first names ______ Term/ Special, Academic year 20 __ • 20__

PRINT LAST NAME FIRST NAME M.I. COLLEGE/PROGRAM

TO BE DISCONTINUED:
Course Delivery
C O U R S E S Units Days Time Room Section Schedule
1. - . -
2.
3.
4. l
TO BE ADDED:
Course Delivery
C O U R S E S Units Days Time Room Section Schedule
1.
2.
3.
4.
NEW TOTAL UNITS

Dean or Representative Student's Signature

COPY FOR THE STUDENT UST: S033-00-FO04 rev01 02/22/22

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UST Form No. 6A
04ANGE/DROPCOURSE UNIVERSITY OF SANTO TOMAS
_ _ Ll __ Espana St., Manila-; Philippines

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Place a comma ( , ) between last and first names ______ Term/ Special, Academic year 20 __ • 20__
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PRINT LAST NAME FIRST NAME M.1. COLLEGE/PROGRAM

TO BE DISCONTINUED:
Course Delivery
C O U R S E S Units Days Time Room Section Schedule
1.
2.
3.
4.

TOBE ADDED:
Course Delivery
C O U R S E S Units Days Time Room Section Schedule
1.
2.
3.
4.
NEW TOTAL UNITS

Dean or Representative Student's Signature

COPY FOR THE DEAN
UST: S033-00-FO04 rev01 02/22/22