Rizal, Philippines

TENTATIVE AND ASSESSMENT FORM

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

Applicant No : TA202200209 Full Name : JOHN STEVEN LIPIO Sex : Male
Course : BSC Major : Year Level/Status : 1st-REGULAR
Home Address : #17 ROSALES APARTMENT, COL. GUIDO EXTENSION, PAG-ASA, Contact Number : 09260074924
BINANGONAN, RIZAL

Subject/s Section Lab Units Lec Units Days Time and Date Room
OLIT01 OLTA122E009 1 3 MWF 07:00 pm - 08:00 pm Jan 12, 2023
OLPECRIM02 OLTA122E009 0 2 MWF 08:00 pm - 09:00 pm Jan 12, 2023
OLNSTP-2C OLTA122E009 0 3 MWF 09:00 pm - 10:00 pm Jan 12, 2023
OLVAL01 OLTA122E009 0 3 TTHS 07:00 pm - 08:00 pm Jan 12, 2023
OLSS01 OLTA122E009 0 3 TTHS 08:00 pm - 09:00 pm Jan 12, 2023
OLSTS01 OLTA122E009 0 3 TTHS 09:00 pm - 10:00 pm Jan 12, 2023

Tuition Fee Laboratory Fee Miscellaneous Fee Special Subject Total Amount

2,145.00 0.00 2,270.00 0.00 4,415.00

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
TOTAL Php 5,625.00

Cash Payment Installment Payment Schedule

Php 5,183.50 Amount Due Dates Late Payments Penalties
Down Payment 1,250.00 Jan 12, 2023 5% Jan 13 onwards
10% Cash Discount 1st Installment 1,102.50 Feb 01, 2023 5% Feb 02 onwards
2nd Installment 1,102.50 Feb 16, 2023 5% Feb 17 onwards
for FULL PAYMENT 3rd Installment 1,102.50 Mar 01, 2023 5% Mar 02 onwards
4th Installment 1,102.50 Mar 16, 2023 5% Mar 17 onwards
made on or before 5th Installment 490.00 Apr 01, 2023 5% Apr 02 onwards
TOTAL 6,150.00
Jan 11, 2023

I shall abide by all the rules and regulations now enforced or may be promulgated by the School Management System from time to time, likewise,
I agree to the cancellation of the credits I have earned in subjects and have enrolled under false pretensed.

REMINDER: Date & Time Accomplished

Upon completion and printing of this PRE-ENROLLMENT, payment of either in CASH or DOWN PAYMENT
06:01PM / 17 Jan 2023
MUST BE SETTLED WITHIN 48 HOURS otherwise class schedules will be automatically deleted.

Prepared by: JOHN STEVEN LIPIO