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Republic of the Philippines Republic of the Philippines

University of Southeastern Philippines University of Southeastern Philippines


Office of the Advanced Studies Office of the Advanced Studies
Iñigo St., Bo. Obrero, Davao City 8000 Iñigo St., Bo. Obrero, Davao City 8000

ORDER OF PAYMENT ORDER OF PAYMENT

Control No.: ________________ Control No.: ________________


Name of Client: _________________________________ Name of Client: ________________________________
Contact Number: ________________________________ Contact Number: _______________________________
Academic Program/Year Level: _____________________ Academic Program/Year Level: ____________________
Date: ____________________ Date: ____________________

DESCRIPTION COST DESCRIPTION COST

Testing Fee Testing Fee

 Admissions Test Php 750.00  Admissions Test Php 750.00


 Clinical _______________________  Clinical _______________________
 Employment _______________________  Employment _______________________
 Others (specify) _______________________  Others (specify) _______________________

Total Cost: Php 750.00 Total Cost: Php 750.00

By: Noted by: By: Noted by:

Aimee Rose O. Larida Dr. Jeneifer C. Nueva Aimee Rose O. Larida Dr. Jeneifer C. Nueva
OAS Staff OAS Dean OAS Staff OAS Dean

Form No. : PM-USeP-RGC-05 Form No. : PM-USeP-RGC-05


Issue Status : 01 Issue Status : 01
Revision No. : 00 Revision No. : 00
Date Effective : 10 October 2016 Date Effective : 10 October 2016
Approved by : President Approved by : President

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