OFFICE OF THE REGISTRAR

2544 Taft Avenue, Manila, Philippines 1004 REQUEST FOR TRANSFER

Phone No. (632) 230-5100 loc.
(Taft) 1321 – 1324 (AKIC) 2333 – 2334 (SDA) 3323 - 3325 CREDENTIALS
Email add.: registrar@benilde.edu.ph

DUE
DATE OF RELEASE: DATE SUBMITTED TO RO:
DATE:

STUDENT NUMBER DEGREE PROGRAM

S S S ✓

PERSONAL INFORMATION INSTRUCTIONS:

1 Fill-out the form and secure clearance from the offices indicated in the clearance
Tomelden box below. This request will not be processed if there is a pending clearance from
any unit/offices/departments. ra a c r c ara c
Last Name h c ara c a h m

John Kenneth If cleared from any accountability, pay the processing fee at the Finance
Department. You may pay through the Cashier Window or the Benilde Online
First Name Payment Portal [https://apps1.benilde.edu.ph/payonline].

Rosario After payment, submit duly accomplished form to the Registrar’s Office through the
respective Records Associate-Admissions for processing.
Middle Name
4 Processing will take 15 working days.

0 9 - 2 1 - 1 9 9 0 Present your Official Receipt (OR) to the Registrar’s Office upon claiming. If the
request was made through www.papeles.ph, the Certificate of Transfer Credentials
Date of Birth (MM-DD-YYYY)
will be shipped to your provided address.

IMPORTAN REMINDERS:
0 9 1 7 3 0 5 9 6 4 5 1. This document can only be issued ONCE.
Contact Number(s)
2. For representative, please present the following during filing of the
request and claiming:
kennethrtomelden@gmail.com a)
b)
Letter of Authorization from the student, duly signed by both parties.
Photocopy of the student’s Benilde ID Card or any valid ID
Email Address c) Photocopy of the representative’s any government-issued valid ID.

REASON FOR TRANSFER: required document before gradua>on in Trinity university of Asia, prep for Board exam

REQUESTED BY: John Kenneth R. Tomelden Jan 11,2024

Student’s Complete Name Student’s Signature Date

PARENT CONSENT: Melita R. Tomelden Jan 11,2024

Parent’s Complete Name Parent’s Signature Date

REQUIRED CLEARANCES
AUTHORIZED ASSOCIATE AUTHORIZED ASSOCIATE
OFFICE/DEPARTMENT DATE
COMPLETE NAME SIGNATURE
Benilde Well-Being Center
[ bwc@benilde.edu.ph ]

Center for Restorative Discipline

[ crd@benilde.edu.ph ]
Center for Scholarships and Grants
(for scholars only)
[ scholarships@benilde.edu.ph ]
Finance Department
[ vc.finance@benilde.edu.ph ]
RO Student Visa
(for International Students only)
[ RO.StudentVisa@benilde.edu.ph ]
Sports Equipment Warehouse
mar h

ABMMA Laboratory
(for ABMMA students only)

BS-ID Laboratory
(for BS-ID students only)

SHRIM Laboratory
(for SHRIM students only)

Others:

FOR REGISTRAR’S OFFICE USE ONLY

VERIFIED BY:
Records Associate’s Complete Name Records Associate’s Signature Date

PROCESSED BY:
Records Associate’s Complete Name Records Associate’s Signature Date

CERTIFICATE OF
TRANSFER CREDENTIALS
RECEIVED BY:
Student’s Complete Name Student’s Signature Date

RO-ADM F001
REVISED March 14, 2023
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