Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

ACCOUNTING DEPARTMENT STUDENT ACCOUNT SECTION

OPT – OUT WAIVER / VOLUNTARY CONTRIBUTION FORM

(R.A. 10931 UNIVERSAL ACCESS TO QUALITY TERTIARY EDUCATION ACT)

I, ________________________________________________________, a ______ Year(Yr. Level) student

of the _______________________________________(Course), is fully aware of Rule II, Sections 8 “Opt-
Out Mechanism”1 and 9 “Student Voluntary Contribution Mechanism”2 of the Implementing Rules and
Regulations of R.A. 10931 (Free Higher Education Act)3 and would like to voluntarily:

Please check ☑ only one.

☐ OPT-OUT (_____ Semester of School Year 20____ - 20____)
Reason for opting out:

☐ Financial capacity to pay ☐ Others (Please specify): _________________________

☐ CONTRIBUTE A PARTICULAR FINANCIAL AMOUNT while still availing the Free Higher
Education Act. (_____ Semester of School Year 20____ - 20____)
Amount of contribution = ___________________________________________(Php_______.___)
(in words)

Important Notice: Students who opt-out must also pay all required fees outside of his/her Tuition
and Miscellaneous Fees including Graduation Fees, Certification Fees, Notarial and other related
Fees if applicable.

I understand that by voluntarily opting out of the free higher education provision, I shall pay the
amount equivalent to the assessed tuition and other school fees of the University.

Student’s Signature: _______________________________ Date: ___________________

Student ID Number: _______________________________

(To be accomplished if Student is below 18 years old)

Name & Signature of Parent / Guardian: _____________________________________________

Steps in Student Voluntary Contribution:

1. Get an Order of Payment in the Accounting Department Student Account Section.
2. Pay at the Fund Management Office (Cashier) and get an Official Receipt (OR).
3. Give a copy of your OR to the Accounting Department Student Account Section.

Note: Please return the completed form to the Student Account Section, Accounting Department, Ground Floor,
South Wing, Mabini Campus (Main), Anonas Street, Sta. Mesa Manila 1016.

1 Section 3(tt) Opt-out refers to the voluntary decision of the student to forego the benefits of the Free Higher Education in
SUCs and LUCs in Section 4 of the Act and Free TVET in Post-Secondary TVIs in Section 5 of the Act and instead pay the
institution the amount equivalent to the waived subsidy;
2 Section 3 (www) Voluntary contribution refers to the decision of the student to contribute at his/her free will some financial

amount to the SUC, LUC, or State-run TVI, even while availing himself/herself of the free higher education or free TVET
provisions in the Act; and
3 Section 8 xxx The decision of the student to voluntarily opt out must be made during the enrollment period

for each semester/term and shall be considered final and irrevocable for that particular semester/term.
Students who opt out will be allowed to change their decision in subsequent semesters/terms. xxx

PUP A. Mabini Campus, Anonas Street, Sta. Mesa, Manila 1016

Direct Line: (5) 335-1730 | Trunk Line: (5) 335-1787 or 335-1777 local 258
Website: www.pup.edu.ph | Email: accountingss@pup.edu.ph

THE COUNTRY’S 1st POLYTECHNICU

 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE HILIPPINES
OFFICE OF THE PRESIDENT
_____________________________________________________________________________________

TO : ALL CONCERNED

SUBJECT : INTERNAL GUIDELINES FOR OPT-OUT AND VOLUNTARY

CONTRIBUTION OF STUDENTS UNDER RA 10931

DATE : MARCH 4, 2022

Section 1.0 BACKGROUND

Section 8 of the Implementing Rules and Regulations (IRR) of Republic Act (RA) No. 10931,
known as the “Universal Access to Quality Tertiary Education Act of 2017” mandates all State
Universities and Colleges (SUCs) to create a mechanism to enable students with financial
capacity to pay for their education and voluntarily opt out of the subsidy for tuition and other
school fees. It states that the decision of the student to voluntarily opt out must be made during
the enrollment period for each semester and shall be considered final and irrevocable for that
particular semester. Students who opt out will be allowed to change their decision in
subsequent semesters. Students who voluntarily opt out of the free higher education provision
shall pay during the enrollment period an amount equivalent to the assessed tuition and other
school fees, which shall be based on the policy of composite fees formulated by the UniFAST
Board, subject to the transitory provisions in Section 54 of the IRR. Students who choose to
voluntarily opt out of the provision shall sign and submit a waiver to the SUC they are enrolling
in. The SUC shall develop a pro-forma waiver, which shall be notarized by the institution.
Students who successfully opt-out of the free higher education provision during a semester /
term shall be exempt from the civic obligation during the same semester / term.

Section 9 of the IRR of RA No. 10931 also requires SUCs to create a mechanism for Student
Voluntary Contribution to enable students with the financial capacity to pay for their education
to voluntarily contribute a particular financial amount to the SUC while availing themselves of
the free higher education provision. The decision of the student to pay any amount as voluntary
contribution to the school must be made during the enrollment period for a particular semester
and shall be considered final and irrevocable for that semester. These students shall be
allowed to change their decision in subsequent semesters. Students who choose to pay a
voluntary contribution shall sign and submit a Voluntary Contribution Form to the SUC which
they are enrolling in. The SUC shall develop a pro-forma contribution form, which shall be
notarized by the institution.

Pursuant to the above provisions, the Polytechnic University of the University hereby adopts
this Internal Guidelines for the opt-out and voluntary contribution of students under RA 10931.

Section 2.0 PROCEDURE

2.1 OPT-OUT
2.1.1 During enrollment of every Semester, students may decide to voluntarily forego
his/her benefits under Free Higher Education (RA No. 10931) by clicking the link to
download a Waiver Form and accomplish it before the end of the adjustment period.
2.1.2 After accomplishing the Waiver Form, the student must then submit it to the Student
Account Section – Accounting Department (Ground Floor, South Wing Bldg., PUP
Main Campus, Sta. Mesa Manila) or attach and send the form with SUBJECT:
voluntarily opt out of the subsidy for tuition and other school fees to the
following email address:

accountingss@pup.edu.ph and/or

dlmartinez@pup.edu.ph

PUP A. Mabini Campus, Anonas Street, Sta. Mesa, Manila 1016

Direct Line: (5) 335-1730 | Trunk Line: (5) 335-1787 or 335-1777 local 258
Website: www.pup.edu.ph | Email: accountingss@pup.edu.ph

THE COUNTRY’S 1st POLYTECHNICU

 Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE HILIPPINES
OFFICE OF THE PRESIDENT
_____________________________________________________________________________________
2.1.3 Wait until the voluntarily opt out of the subsidy for the current semester is processed
and students shall be instructed to pay the tuition and other through a Notice from
the Accounting Department that will be sent via email or through their SIS Account.

Please take note that Waiver Forms received after the adjustment period will no longer be
processed. Lastly, OPT-OUT is only for students who had qualified under Free Higher
Education (RA No. 10931).

2.2 VOLUNTARY CONTRIBUTION

2.2.1 While still availing his/her benefits under Free Higher Education (RA No. 10931),
students may contribute to the University by clicking the link to download a Voluntary
Contribution Form in his/her SIS Account.
2.2.2 After accomplishing the Voluntary Contribution Form, the student must then get an
Order of Payment in the Accounting Department-Student Account Section (Ground
Floor, South Wing Bldg., PUP Main Campus, Sta. Mesa Manila) or attach and send
the form with SUBJECT: Voluntary Contribution Form to the following email
address:

accountingss@pup.edu.ph and/or

dlmartinez@pup.edu.ph

2.2.3 Pay at the Fund Management Office (Cashier) and get an Official Receipt (OR).
2.2.4 Give a copy of the OR to the Accounting Department-Student Account Section

Please take note that Voluntary Contribution Forms received after the student had
graduated will no longer be processed.

Section 3.0 FORMS

The OPT – OUT WAIVER / VOLUNTARY CONTRIBUTION FORM is attached herein as

Annex “A” and may be downloaded from the student’s SIS Student Account.

Section 4.0 EFFECTIVITY

These guidelines shall take effect immediately.

PUP A. Mabini Campus, Anonas Street, Sta. Mesa, Manila 1016

Direct Line: (5) 335-1730 | Trunk Line: (5) 335-1787 or 335-1777 local 258
Website: www.pup.edu.ph | Email: accountingss@pup.edu.ph

THE COUNTRY’S 1st POLYTECHNICU