sq _ Request for Academic Records / ~ a~Y } Transcripts INTE IONALe y's Order # 3627610, 34600 Market Stsuite 400, Philadelphia, PA 19104 # evening < St : "Please sign, date and send this form to your professional school (or where your Academie Records Transcripts are archived) to have an authorized official complete the remaining information ‘Current Name: Karem Pantaleon Monte de Ramos Name When Attended ‘School i Difleren): Other Names: Nameot choot; O€ LOS SANTOS - STI COLLEGE, INC (FKA DE LOS SANTOS-STI COLLEGE OF HEALTH PROFESSIONS, ‘ ING.) (DE LOS SANTOS- STI COLLEGE INC) Dates of Attendance: November 2006 May 2011 Date of Birth: April 4, 1989 Email: _akosikarem@gmail.com ‘Telephone: 116 Hessian Hills Ridge Apt 3 Malling Addr: Charittesvile Virginia 22901-UNITED STATES OF AMERICA 1, Karem Pantaleon Monte de Ramos, hereby give my consent to DE LOS SANTOS - STI COLLEGE, INC (FKA DE LOS SANTOS-STI COLLEGE OF HEALTH PROFESSIONS, INC.) (DE LOS SANTOS- STI COLLEGE INC) to provide CGFNS International, In. the requested information with supporting nursing education documents. ‘Mont Jan, Feb, Mu, Year “Applicant Signature: bat Signet: Cheat a Attention: This is a customized form for use only by the applicant and Institution identified below. Do not duplicate this form for any other applicant or institution, Questions?: Contact CGFNS International at +1 (215) 222-8454 Monday through Friday from 9:00 am to 4:00 pm (U.S. Eastern Time). Karem Pantaleon Monte de Ramos | DE LOS SANTOS - STI COLLEGE, INC (FKA DE LOS SANTOS-STI COLLEGE OF HEALTH PROFESSIONS, INC.) (DE LOS SANTOS- STI COLLEGE INC) ‘Order #: 03627610 | Doc ID #: DS2372843 | November 10, 2023 | Rev K’Mar. 2023 | Page I of 5 (©2023 CGFNS International, Inc. All rights reservedReresca Crrr Cee yan) ere eat cy ‘To School Official, |. Complete all areas on this form. All documents must have a certified English transation (i notin English). 2. Attach an official Academic Record / Transcript of this applicant's nursing education. This i the official documentation or record ofthis applicants courses, credits / clock hours, grades achieved, theory and laboratory hours, and clinical practice hours, and credentials eared. If ‘document isnot in English, also include a centfed English translation 3. Place the schools official seal / stamp over the flap ofthe school's envelope (marked with a return address) that contsns the completed form and requested documents. 4. Send via postal mail (preferably trackable) to: (CGFNS Ineerationl $3400 Markt treet, Suits 400, Philadciphia, PA 1910-2681 USA, ‘Studest Date of Bit ‘Student Name When Atended Mont dan. eb Mac) vol ‘School Name When Student Atendd: Curent Schoo or Authority Name Where Academic Records / Transcripts ae Archived (i diferent sams) Curent Schoo Suost Ades (P.O. Box, i needed iy State Province: Postal Code: ‘County ‘School Teleghone Number: ‘School Woh Address: Schoo! Registrar Const Emi: ‘Schoo! Registra Fux Number Attention: This is a customized form for use only by the applicane and Institution identified below. Do not duplicate this form for any other applicant or institution. Questions?: Contact CGFNS Intemational at +1 (215) 222-8454 Monday through Friday from 9:00 am to 4:00 pm (U.S. Eastern Time), Karem Pantaleon Monte de Ramos | DE LOS SANTOS - STI COLLEGE, INC (FKA DE LOS SANTOS-STI COLLEGE OF HEALTH PROFESSIONS, INC.) (DE LOS SANTOS. STI COLLEGE INC) Order #: 03627610 | Doc ID #: DS2372843 | November 10, 2023 | Rev K’Mar. 2023 | Page 2 of 5 (©2023 CGFNS International, Inc. All rights reservedRTC a ae at Rat oy Cee yan) Please provide spectc theory and clinical hours for all nursing domains and subject areas Isted below. Please DO NOT combine the nursing ‘domains or subject areas. I! they are combined in your curicuum, estimate the teary and circa hours each nursing domain and each subject area, 1 | Ads Media Nusing 1234 2 | Ae Surgical Nursing 1236 3__| Metematatan: excusing Gynecology) ie a4 4 | Nursing Care of Cicten 12 ae Pychatie Menta Heats exeiing Community Heath Concops CGeritic Nursing Gerontcoay) Physical Assocomant + 2a ‘Anatomy and Phyrileay Geng Body Stuture and Funeion) Ethical Consideratons Heath Counseling Human Growth and Doveopment ‘Toughout the Llaspan| 2 | trierpersonal Relationships 8 Leadership Nursing 40 | Legal Aspecsin Nursing $1 erzona and Family Hoth Concopte 42 aon 18 Pharmacobgy and Adrinstation of | Medeators 14 Protessona Roles & Functions * Do not include classroom education, labortoy, simulation, and planned clinical conferences (ward teaching) hou's. CGFNS Intemational must have the breakdown of theory hours and applicable clinical hours for all nursing domains and subject areas. Attention: customized form for use only by the applicane and Institution identified below. Do not duplicate this form for any other applicant or institution. Questions?: Contact CGFNS Intemational at +1 (215) 222-8454 Monday through Friday from 9:00 am to 4:00 pm (U.S. Eastern Time), Karem Pantaleon Monte de Ramos | DE LOS SANTOS - STI COLLEGE, INC (FKA DE LOS SANTOS-STI COLLEGE OF HEALTH PROFESSIONS, INC.) (DE LOS SANTOS. STI COLLEGE INC) Onder #; 03627610 | Doc ID #: DS2372843 | November 10, 2023 | Rev K’Mar. 2023 | Page 3 of 5 (©2023 CGFNS International, Inc. All rights reservedRequest for Academic Records / Transcripts Order # 3627610 ‘School Official, please complete all areas: Lanai Scns Hest anf St Pen Cao Sa , Coupe of Stuy (Nui / Pata chi Mie: Nag of Cee / Digna Degree Obi a Org Language J og Tp Mr nl oe D1 Dito [Ci ceritcawe [Casocine ewes | C] tcestrst’s Deere] Bo 1D Destonte Tr ome esi _Atendatce Dies: Mon a eb Mu) Ye Mont dan Feb May.) Yess Die Applicant Cant he Progra? (Marcy 2 Ye-ba ORE [Os -pitnaconee ‘Wa hie Sel Acer GovermetApprovd When Stent Gimploud be Coes or 11s, Name of Organza at Acad Appel hi Sea: (otk caly on | Oven Ox 11s nt ate Scot ws Accel Approved 11es(and renewed), Lat De Schoo was Renewed Acre or Approved: sh Gan Ra ear Son Gun Re Mat) ay var Wis Nursing aan Program Ascaid fGovernet ‘moved When Sdn Compe he Caner Gra? 11s, Name of Organon at Asti Appel hs Nang Education Programa (tak caly one: | ves Os 11 Yes Ina Date Norsng Eduction Program ws Aseitbor—_-IFYesand new), Last Date Nursing Eaton was Renewed Acre oc AppOve ‘Append Math dan Fe Nr, ba ver Mon dan Feb. M) Da ver (an authorized schoo! offical) hereby attest thatthe information provided on this form is accurate and the enclosed Academic Records / ‘Transeripts accurately states the courses taken by Karem Pantaleon Monte de Ramos. Please sin, print name, date and PLACE OFFICAL SEAL / STAMP BELOW (without a signature, printed name, tte, date signed and official school seal / stamp these documents will not be accepted). Month an, Feb, Mat, Yeu ‘Schoo Ofc Signature ( int Name of Scot Ot: ‘School Of Tite: Place School Authority's Seal / Stamp anywhere in this box. Attention: This is a customized form for use only by the applicant and Institution identified below. Do not duplicate this form for any other applicant or institution. ‘Questions? Contact CGFNS International at +1 (215) 222-8454 Monday through Friday from 9:00 am to 4:00 pm (U.S, Eastern Time). Karem Pantaleon Monte de Ramos | DE LOS SANTOS - STI COLLEGE, INC (FKA DE LOS SANTOS-STI COLLEGE OF HEALTH PROFESSIONS, INC.) (DE LOS SANTOS. STI COLLEGE INC) Order #: 03627610 | Doc ID #: DS2372843 | November 10, 2023 | Rev K:Mar. 2023 | Page 4 of 5 (©2023 CGFNS International, Inc. All rights reservedNemes yefe UK oe Required Documents: Please indicate the number of pages for each required document to make sure that all documents are accounted for. If the document is not paper, please indicate this by writing "E-media" Enter Number of Required Documents Pages Academic Records Form (This form) Included Page(s) Official Records / Transcript Included Page(s) Additional Documents: When any additional documents are included, please explain: Enter Additional Document Number of Pages Description of Additional Document: Included Pages Missing Documents Explanation: CGFNS will likely refuse packages that lack required items, as we cannot conduct the necessary evaluation for the applicant. If you cannot provide a mandatory document, please provide an explanation in the space provided below: Attention: This is a customized form for use only by the applicant and Institution identified below. Do not duplicate this form for any other applicant or institution, mns?: Contact CGFNS International at +1 (215) 222-8454 Monday through Friday from 9:00 am to 4:00 pm (U.S. Eastern Karem Pantaleon Monte de Ramos | DE LOS SANTOS - STI COLLEGE, INC (FKA DE LOS SANTOS-STI COLLEGE OF HEALTH PROFESSIONS, INC.) (DE LOS SANTOS- STI COLLEGE INC) ‘Onder #: 03627610 | Doc ID #: DS2372843 | November 10, 2023 | Rev K’Mar. 2023 | Page 5 of 5 (©2023 CGFNS International, Inc. All rights reserved