Republic of the Philippines

Marinduque State College

Panfilo M. Manguera Sr. Road, Tanza, Boac, Marinduque

CERTIFICATE OF REGISTRATION AND BILLING

Registration No: 278641 Academic Year/Term : 2nd Semester AY 2021-2022

STUDENT GENERAL INFORMATION
Student No: 16B0288 College: College of Engineering, Information & Industrial Technology
Name: PIELAGO, Marco Pelobello Program: Bachelor of Science in Industrial Technology
Gender: M Major: Electrical Technology Curriculum: BSIT-Curriculum ET AY 2007-
Date of Birth: April 18, 1996 Year Level: 4th Year Scholarship/Discount: UniFAST Free Higher Education
Tuition & Other School Fees
U N I T
CODE SUBJECT TITLE Lec Lab Credit
SECTION SCHEDULE / ROOM FACULTY
OJT 2 On-the-Job Training (OJT 2) 0 16 16 BSIT 4A-ELECT MTWThF 8:00 AM - 5:00 PM Prof. Renato N. Jogno
(OLD)
OJT 1 On-the-Job Training (OJT 1) 0 5 5 BSIT 4A-ELECT MTWThF 8:00 AM - 5:00 PM Prof. Renato N. Jogno
(OLD)
Total Subject/s: 2 Total Unit(s) 0 21 21

PLEDGE UPON ADMISSION

A S S E S S S E D F E E S
Upon admission to the Marinduque State College(MSC), I hereby
Free Higher Education
promise with sincerity to obey all the existing rules and regulations
Tuition Fee TF@21 3,297.00
established by the authorities of this institution.
Athletic Fee 100.00
Please check Library Fee 150.00
ORF/COR 100.00
Grantee of R.A. 10931 (Free Tuition)
SCUAA Fee 100.00
Non Grantee AVR Fee 100.00
Culture and Arts Fee 90.00
As grantee of R.A. 10931 I will take into consideration the following: SSF/SSC/Pub 70.00
1. The grantee of R.A. 10931 (UNIVERSAL ACCESS TO QUALITY Medical/Dental Fee 75.00
TERTIARY EDUCATION) understands and gives consent to Internet Fee 200.00
Marinduque State College (MSC) or its agents appointed to OJT Fee @OJT 2 [2-99-99-990-053] 300.00
facilitate the submission of needed personal data to the UNIFAST
pursuant to the requirement of CHED. The grantee also consents Others
that such personal information may be transmitted outside of MSC Class Cards/FRG 50.00
for transactions in relation to RA 10931. Testing Materials 20.00
TOTAL ASSESSED 4,652.00
2. Shall render the required return service before graduation of the
DISCOUNT 4,582.00
baccalaureate degree after having benefited from RA 10931.
NET ASSESSED 70.00
TOTAL PAYMENT 0.00
Student Signature: OUTSTANDING BALANCE 70.00

OR No. : Amount :
Address: Buyabod, Sta. Cruz, Marinduque

Data Privacy Consent:In accordance with RA 10173 or Data RELEASED BY:

Privacy Act of 2012, I consent to the following terms and conditions
on the collection, use, processing and disclosure of my personal
data: (1). I am aware that Marinduque State College (MSC) has
collected and stored my personal data during my admission. These
data include my demographic profile, contact details like EnrollmentOfficer
addresses, email address, mobile numbers. (2). I express my
consent for MSC to collect, use, record, disclose, transfer, store,
APPROVED:
organize, update, monitor and/or process my personal information.
(3). I agree to personally update these data thru email request as
needed. (4). Towards the efficient management of the school
records, l authorize MSC to manage my data for data sharing with GEMMA A. TIROL, MPA
accredited company/industry partners, and government agencies.
(5). To ensure the protection of my rights as a data subject, l College Registrar
understand that MSC shall warrant to me the following right/s:
Received notices on changes in the above-cited purposes for my
data processing, or personal data breaches provided for in Section
39 of the Data Privacy Act's Implementing Guidelines; (6). I hereby
affirm my right to be informed, object to processing, access, and
rectify and to suspend or withdraw my personal data pursuant to
the provisions of the RA 10173 and its implementing rules and
regulations. I warrant that l have read, understood all of the above
provisions, and agreed with its full implementation.

Date of Registration : January 21, 2022

Date Printed : February 17, 2022

KEEP THIS CERTIFICATE. YOU WILL BE REQUIRED TO PRESENT THIS IN ALL YOUR DEALINGS WITH MARINDUQUE STATE COLLEGE.