The Rizal Memorial Colleges, Inc.
Picture
Passport size
RMC Building, Poblacion 7-A, Lopez Jaena & F. Torres Streets, w/ name tag
Marfori Heights, Davao City
Telephone No. (082) 300-7173 Local 112
CRUZ, LYN YU
(sample)
APPLICATION FOR GRADUATION
________JULY 9, 2021_____________
Date of Graduation
The Registrar
Rizal Memorial Colleges
Sir/Ma’am:
I wish to apply for graduation for the degree/title of MASTER OF ARTS Major in Educational Management I am presently
enrolled a total of 6 units this 2nd Semester School Year 2020-2021 .
PERSONAL INFORMATION
DUALLO MARIA LUTZ BASOBAS
(Family Name) (First Name) (Middle Name)
Birthday JUNE 9, 1988 Birthplace SINDATON, PANABO Contact No.09659434775
Complete Address PUROK 3 SINDATON, PANABO CITY
Name of Parents/Guardian/Spouse JORNIE I. DUALLO Contact No. 09971047005
EDUCATIONAL ATTAINMENT
Name of School Address Year Graduated
Primary (Grade 1-4) La Filipina Elementary School La Filipina, Tagum City
Intermediate (Grade 5-6) A.O. Floirendo Elementary School A.O. Floirendo, Panabo City 2000
High School A.O. Floirendo National High School A.O. Floirendo, Panabo City 2004
Transferee/College Davao del Norte State College New Visayas, Panabo City 2008
Previous School
If Employed
SINDATON NHS- DEPED SINDATON, PANABO CITY TEACHER I 09659434775
Name of Company Address Position Contact Number
Awards/Scholarship Received OUTSTANDING GUIDANCE ADVOCATE- DIVISION LEVEL
Membership in Organization/Club include position/s (may use another sheet):
SWORN STATEMENT
I further abide with the following conditions:
1. That if I am not qualified this semester/summer, due to Dropped/INCs/failing grades/pre-requisite courses, I am willing to re-
enroll or retake the deficiencies in order to complete my program of studies for a degree.
2. That I will comply with the necessary requirements within one (1) semester before the last day of final schedule of the term.
Failure to comply within this given time, I automatically revoke my application for graduation.
3. That as candidate for graduation, I will settle all my financial obligations before I will be allowed to participate in all activities
related to graduation requirement.
4. That I executing this sworn statement to attest to the foregoing facts.
_ MARIA LUTZ B. DUALLO
Applicant (Signature over Printed Name)
06-14-2021
Date
Noted:
Dean (Signature over Printed Name)
Date: _________________________