Rizal, Philippines

OFFICIAL REGISTRATION AND ASSESSMENT FORM

Campus : Rizal Academic Term : Second TrimesterAcademic Year : 2022-2023

Student Number : TA190719 LRN : Year/Status : 4th-REGULAR
Full Name : AL VINCENT PENDON MIRAVALLES Sex : Male
Course : BSA Major : Contact # : 9666128521
Home Address : BLK. 20, LUPANG ARENDA BRGY. STA. ANA, TAYTAY, RIZAL.

Subject/s Section Lab Units Lec Units Days Time and Date Room
OLINTEG ACTG1 LFTA422N002 0 2 S 03:00 pm - 06:00 pm B4-60
OLINTEG ACTG2 LFTA422N002 0 2 S 07:00 pm - 10:00 pm B4-60
OLACTG PRAC LFTA422N002 0 6 SUN 02:00 pm - 03:00 pm
OLINTEG ACTG3 LFTA422N002 0 2 SUN 03:00 pm - 06:00 pm B4-60
OLINTEG ACTG4 LFTA422N002 0 2 SUN 07:00 pm - 10:00 pm B4-60

Tuition Fee Laboratory Fee Miscellaneous Fee Special Subject Total Amount

1,820.00 0.00 2,270.00 0.00 4,090.00

Other Fees 100.00

LMS Fee 300.00
Student Portal Fee 300.00
Drug Test 200.00
Mailing Fee 60.00
Health Diagnostics 250.00
Test Booklet 30.00

X Fullpayment Installment FULLPAYMENT X Regular Fees TOTAL Php 5,330.00

with Discount
10% Cash Discount if FULL PAYMENT Php 4,921.00 made on or before Jan 11, 2023
EXAMINATION PERMIT Installment Payment Schedule
CONTROL NUMBER Amount Due Dates Late Payments Penalties
Full Paid (Cash Basis) Down Payment 1,280.00 Jan 12, 2023 5% Jan 13 onwards
000000 1st Installment 1,020.60 Feb 01, 2023 5% Feb 02 onwards
2nd Installment 1,020.60 Feb 16, 2023 5% Feb 17 onwards
Installment Basis 3rd Installment 1,020.60 Mar 01, 2023 5% Mar 02 onwards
Prelim - 4th Installment 1,020.60 Mar 16, 2023 5% Mar 17 onwards
Midterm - 5th Installment 453.60 Apr 01, 2023 5% Apr 02 onwards
Final - TOTAL 5,816.00

REMARKS:
This form must be presented and acknowledged by the Instructor / Professor during your first day of
class attendance; by signing at the back of the Accounting's Copy hereby affirmed your acceptance
of the School Rules and Regulations. Control No.: 01059540