Republic of the Philippines

CEBU TECHNOLOGICAL UNIVERSITY

MAIN CAMPUS
M. J. Cuenco Avenue Cor. R. Palma Street, Cebu City, Philippines
Website: http://www.ctu.edu.ph E-mail: registrar.main@ctu.edu.ph
Phone: +6332 402 4060 loc. 1105

OFFICE OF THE UNIVERSITY REGISTRAR

REQUEST FORM FOR DOCUMENTS

REQUEST DETAILS: (Put a√ mark.) First Request? Yes No

DOCUMENT(S): PURPOSE (required for TOR & Certification/Letter)
CAV Comprehensive Exam Employment -Local Promotion
Certified Copy Design Hearing Oral Defense Ranking
Diploma Educational Assistance Personal File Scholarship
TOR Employment Abroad PRC Licensure Examination Transfer
Certification /Letter : Others:
CTU (former CSCST) Grade(s) of Cross Enrollee S.O. Exemption
Earned Units/CAR Graduation English Language as Medium of Instruction
Enrolment GWA No Objection S.P. to Cross Enroll
Others:
Number of Copy(ies):
CLIENT DETAILS: (Fill out the spaces) Day
Student I.D. No.: Program & Major: Evening
Name:
Family Name First Name Middle Name
Maiden/Other Name: Civil Status:
Permanent Address: Contact No.:
Email Address:
Parent /Guardian/Spouse:
First Semester of Attendance: Last Semester of Attendance:
Certificate or Degree Graduated: Date of Graduation:
REGISTRAR'S OFFICE ACTION:
Please pay to the Cashier.
CAV ₱40.00 Student Signature Date
Certified Copy ₱40.00
Certification/Letter ₱40.00
Diploma 200 / 300 Tentative Claim Date:
Doc. Stamp ₱30.00
TOR No. of pp. X 50 / 75

Total Assessed by:

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CLAIM SLIP
Name of Student: ID No.: Tentative Claim Date:
Requested Document(s) : Processing Time (in normal circumstances) Mon.-Fri.; 1:00 -5:00pm
1 CAV 7 WD 1
2 Certified Copy 3 WD 2
3 Certification/Letter 3 WD 3
4 Diploma 7 WD 4
5 TOR 7 WD 5
1. CERTIFICATION / LETTER NOT CLAIMED AFTER ONE YEAR SHALL BE DISPOSED.
2. ACADEMIC RECORD(S) CANNOT BE RELEASED WITHOUT YOUR SIGNATURE.
3. I AUTHORIZED THE RELEASE OF MY ACADEMIC RECORD(S).

Student Signature Date Signature over printed name of authorized person