Please attach the ff:

• w/Board Exam. – 2 pcs.

passport size pic.

w/nametag & white

background & 2 pcs.

documentary stamps
• Non-Board – 1 pc.

passport size pic.

w/nametag & 1 pc.

APPLICATIONFORGRADUATION documentary stamp

In accordance with the provisions of the Data Privacy Act of 2012 and its corresponding implementing rules and regulations, we
implement reasonable and appropriate security measures to ensure the security of the personal information we gather. We will
collect, process, and store your personal information for graduation purposes.

I authorize and give my consent to the Office of the University Registrar for the purpose stated above.

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A.NAME: ESTOPACE, RHNIEL NERIZZE MACAPAL Student No. 2019-112147
(Surname) (First Name) (M.Name)
Address: BLK 253 LOT 16 SAMPAGUITA ST. PUROK IV BRGY. STA. CRUZ II, CITY OF SAN JOSE DEL MONTE BULACAN
Telephone No./Cellphone No.: 0977-033-3917
Email Address: rhnielnerizze.estopace.m@bulsu.edu.ph
Course Applied for: Bachelor of Science in Legal Management
Civil Status: Single Sex:Female Age: 22
Date of Birth: November 13, 2000 Place of Birth: City of San Jose Del Monte, Bulacan
Name of Parents/Guardian: Nelda M. Estopace
High School Graduated: Colegio de San Gabriel Arcangel
School last attended: (For transferee only) ___________________________________________________________

B. PRESENT LOAD:
Subject Units Signature of Professor

Methods of Legal Research and Writing 2 3 _________________

Legal Management Internship (320 hrs) 3 _________________
Criminal Law 2 3 _________________
Environmental Science 3 _________________
Religion, Religious Experiences & Spirituality 3 _________________
Philippine Popular Culture 3 _________________

C. THE ABOVE-NAMED STUDENT IS CLEARED OF ALL MONEY AND PROPERTY ACCOUNTABILITIES IN MY

OFFICE

(To be signed by the responsible officials concerned)

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Faculty Adviser: ______________________________ Dean of Student Affairs: _____________________

Librarian: ____________ In charge, Accounting: ______________________Dean: ____________________________

I hereby promise, in case of approval of my graduation to participate in all graduation activities

and pay the required fees.
________________________________
Applicant's Signature
____________4-C______________
Year and Section

D. EVALUATION OF RECORDS BY THE DEAN:

The Dean checks and evaluates the record of the students thru the evaluation provided by the Office of
the Registrar. When completed, this form must be submitted to the Dean’s Office which will forward it to
the Registrar’s Office.
RECOMMENDING APPROVAL:
________________________________
(DEAN)
APPROVED:

ALBERT B. VILLENA, MSIT

Registrar IV
N.B.
All candidates for graduation who have settled all the financial obligations to the University shall receive
their diploma during their graduation ceremonies.

BulSU-OP-OUR-03F1
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