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  • College of Education: Ctu-Online Enrollment Form

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    Niel Ven Bacalangco
    337 views2 pages
    This document is an enrollment form for Cebu Technological University's online courses. It collects personal information from students such as name, address, citizenship, educational background, and course details. It also outlines various fees associated with enrollment like application, tuition, instructional materials, and transcript fees. Students must provide documents like a birth certificate, medical certificate, and transfer credentials if applicable. By signing, the student certifies the truth of the entries and agrees to abide by the school's policies and regulations.

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    Original Title

    CTU Enrolment Form

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    This document is an enrollment form for Cebu Technological University's online courses. It collects personal information from students such as name, address, citizenship, educational background, and course details. It also outlines various fees associated with enrollment like application, tuition, instructional materials, and transcript fees. Students must provide documents like a birth certificate, medical certificate, and transfer credentials if applicable. By signing, the student certifies the truth of the entries and agrees to abide by the school's policies and regulations.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    337 views2 pages

    College of Education: Ctu-Online Enrollment Form

    Uploaded by

    Niel Ven Bacalangco
    This document is an enrollment form for Cebu Technological University's online courses. It collects personal information from students such as name, address, citizenship, educational background, and course details. It also outlines various fees associated with enrollment like application, tuition, instructional materials, and transcript fees. Students must provide documents like a birth certificate, medical certificate, and transfer credentials if applicable. By signing, the student certifies the truth of the entries and agrees to abide by the school's policies and regulations.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 2

    Republic of the Philippines

    CEBU TECHNOLOGICAL UNIVERSITY SYSTEM


    CEBU CITY CAMPUS
    Corner M.J. Cuenco Avenue and R. Palma Street, Cebu City
    Tel # 416-6585 & 412-1400 loc. 106

    COLLEGE OF EDUCATION

    CTU-ONLINE ENROLLMENT FORM

    Date : __________________ Academic Year : ____________________________


    st nd rd
    [ ] New [ ] Old [ ] Transferee Term : [ ]1 [ ]2 [ ]3
    Student ID Number: ________________
    Degree Program : _____________________
    Residency: Major : _____________________
    [ ] Cebu-based [ ] Within Phils. [ ] Foreign/Based Abroad

    PERSONAL DATA
    Name:____________________________________________________ Age: ________ Gender: [ ] Male [ ] Female
    (Last Name) (First Name) (Middle Name)
    Date of Birth:______________ Place of Birth:_____________ Civil Status: [ ] Single [ ] Married Citizenship: _______
    Home Address:______________________________________ Tel. No.: __________ Email: ________________________
    Present Occupation/Position:__________________________ School/Company: ___________________________________
    School/Company Address: _____________________________________________ Tel. No.: ________________________
    Name, Address, and Tel. No. of person to be notified in case of emergency:
    ___________________________________________________________________________________________________

    EDUCATIONAL BACKGROUND
    School Academic Year Honors/Degree Received
    Elementary : ________________________________ ____________________________ _____________________
    High School : ________________________________ ____________________________ _____________________
    College : ________________________________ ____________________________ _____________________
    Post Graduate : ________________________________ ____________________________ _____________________

    ENTRANCE DATA:
    [ ] Form 138-A or TOR (for Transferee) [ ] Birth Certificate [ ] Certificate of Transfer Credentials
    [ ] Certificate of Good Moral [ ] Medical Certificate (for Transferees)
    I hereby certify that all entries are true and solemnly swear to abide by the laws. Policies, rules and regulations set forth by the
    college.
    _________________________________________
    Student Signature over Printed Name

    CASHIER’S COPY
    Name: Gender: Course/Yr. & Sec. I.D. Number:
    Course Nomenclature Course Description Unit/s

    _______________________
    Enrolment Committee/Registrar

    STUDENT’S COPY
    Name: Gender: Course/Yr. & Sec. I.D. Number:
    Course Course Description Unit/s Instructor
    Nomenclature

    _______________________
    Enrolment Committee/Registrar
    REGISTRAR’S COPY
    Name: Gender:
    Course: Year Level: Section:
    Course Nomenclature Course Description Unit/s

    Total

    ____________________________ ____________________________
    Enrolment Committee Cashier / EDP

    APPROVED BY:

    ________________________ _______________________
    Registrar Date of Registration

    ASSESSMENT OF FEES
    CHARGES QTY AMOUNT TOTAL O.R. NO. DATE
    AMOUNT

    Application Fee:
    [ ] Cebu-based
    [ ] Outside Cebu, but within the Phils.
    [ ] Foreign/Based Abroad
    Tuition Fee:
    [ ] Cebu-based
    [ ] Outside Cebu, but within the Phils.
    [ ] Foreign/Based Abroad
    Instructional Materials Fee
    Orientation Fee
    Miscellaneous Fee
    Change of Matriculation Fee
    [ ] Enrollment in additional course
    [ ] Substitution of one course for another
    [ ] Cancellation of a course
    Request for Transcript of Records
    [ ] First Copy
    [ ] Recopy
    [ ] Certification
    Educational Development Fee
    Telecommunications Support and
    Development Fee
    TOTAL PHP
    TOTAL US $

    VALIDATED
    Date : ________________
    Signature: ____________

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