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Pre Registration Form

This document is a pre-registration form for a university. It collects a student's name, ID number, course, major, semester, school year, gender, student type, and scholarship status. The form also includes spaces for subject details and a checklist for student type - either non-paying students who receive benefits under the Universal Access to Quality Tertiary Education Act or paying students who opt out of free education benefits. For paying students under 18, the form requires a parent's signature acknowledging their child's status and waiving education benefits.

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Shein Guerrero
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1K views2 pages

Pre Registration Form

This document is a pre-registration form for a university. It collects a student's name, ID number, course, major, semester, school year, gender, student type, and scholarship status. The form also includes spaces for subject details and a checklist for student type - either non-paying students who receive benefits under the Universal Access to Quality Tertiary Education Act or paying students who opt out of free education benefits. For paying students under 18, the form requires a parent's signature acknowledging their child's status and waiving education benefits.

Uploaded by

Shein Guerrero
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
  • Pre-Registration Form: This page contains fields for student details such as name, course, semester, ID, and includes a section for indicating the payment type.
  • Form Completion and Approval: This page provides sections for student signature, approval by an advisor, and student contact details to complete the registration process.

University of Southeastern Philippines

College of ___________

PRE-REGISTRATION FORM
NAME: ________________________________ ID NO.: ____________________
COURSE: _____________________________ MAJOR: ___________________
SEMESTER SCHOOL YEAR SEX TYPE SCHOLARSHIP
[ ] 1st SEM [ ] MALE [ ] OLD STUDENT

[ ] 2nd SEM 20___ - 20_____ [ ] FEMALE [ ] NEW STUDENT

[ ] OFF SEM [ ] TRANSFEREE

Subject ID Subject Description Units Days Time Room

CHECK THE BOX TO INDICATE THE TYPE OF STUDENT:

NON- PAYING STUDENT (Students who avail the free tuition and other benefits under RA 10931 and commit to
comply with the return service under the act.)

PAYING STUDENT (student who voluntarily opt out of the free higher education provision.

PAYING STUDENT (18 yrs. Old and above)

PAYING STUDENT (17 YRS. Old below)

I hereby declare that, as a parent of minor, I am fully aware of the Republic Act 10931 (Universal Access to
Quality Tertiary Education of 2017) and all the privileges and responsibilities accorded and mandated to my child under
this Act. However, my child voluntarily opts out of the free higher education provision. Thus, I hereby agree that my
child shall waive all the benefits for the ______ Semester of the School Year _____________ for the reason that we are
capable of paying for his/her tuition and other related school fees.

________________________________________ _________________
Signature over Printed Name of Parent/Guardian Date
Approved by:

_______________________________________ _____________________________________
Student Signature Signature over Printed Name of Head/Adviser

Date Signed: ____________________________ Date Signed: __________________________

Student Mobile Number _____________________ Student email address: ___________________________

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