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  • Sample Request Form

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    Michael Kakumoto
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    Original Title

    Sample Request Form - Copy (4)

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    7 views1 page

    Sample Request Form

    Uploaded by

    Michael Kakumoto

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    DISTANCE EDUCATION FOUNDATION, INC.

    REQUEST FORM

    Date Filed: ____________________

    Name: _____________________________________ Course: _________________________


    Present address: _______________________________________________________________________
    Contact No. _________________________________

    Please check (  ) the documents requested


    ________1. Transcript of Records (Purpose: ___________________________________________
    ________2. Honorable Dismissal
    ________3. Good Moral
    ________4. Certification currently enrolled
    ________5. Certificate of Grades
    ________6. Cross-Enroll Permit
    ________7. Others: Please specify: __________________________________________________

    ________________________
    Student Signature

    Transcript (15 working days ) - 100.00 per page


    Certification/Honorable Dismissal/Goodmoral
    ( 5 working days) - 150.00 per page
    Certified true copy - 25.00 per page
    Cross-Enroll permit (5 working days) - 150.00
    Documentary stamp - 15.00
    Diploma - 400.00

    DISTANCE EDUCATION FOUNDATION, INC. REQUEST FORM

    Date Filed: ____________________

    Name: _____________________________________ Course: _________________________


    Present address: _______________________________________________________________________
    Contact No. _________________________________

    Please check (  ) the documents requested

    ________1. Transcript of Records (Purpose: ___________________________________________


    ________2. Honorable Dismissal
    ________3. Good Moral
    ________4. Certification currently enrolled
    ________5. Certificate of Grades
    ________6. Cross-Enroll Permit
    ________7. Others: Please specify: __________________________________________________

    ________________________
    Student Signature

    Transcript (15 working days ) - 100.00 per page


    Certification/Honorable Dismissal/Goodmoral
    (5 working days) - 150.00 per page
    Certified true copy - 25.00 per page
    Cross-Enroll permit (5 working days) - 150.00
    Documentary stamp - 15.00
    Diploma - 400.00

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