Document No.
WVSU-REG-SOI-03-F01
APPLICATION FOR GRADUATION
Issue No. 1
FORM
Revision No. 3
Date of Effectivity: August 15, 2022
WEST VISAYAS STATE
Issued by: Registrar’s Office
UNIVERSITY
Page No. Page 1 of 1
______________________
Date
The Registrar
This University
Sir/Madam:
Please consider me as a candidate for graduation for the degree _________________________
_________________________________________________ in the
____First Semester, AY ________________
____Second Semester, AY ______________
____Summer, 20_______
In this regard, I am respectfully requesting that my academic records be assessed for any deficiencies
in grades and other requirements and for the appropriate action by the Academic Council and the Board of
Regents.
Enclosed is a copy of my Transcript of Records and appraisal form for confirmation.
Thank you.
Very truly yours,
______________________
(Printed Name & Signature)
Endorsed:
____________________________
Class / Program Adviser
(Printed Name & Signature)
Concurred:
____________________________
College Dean
(Printed Name & Signature)
Name : ________________________, ________________________ ___________________
(Last) (First) (Middle Name)
I.D Number : ___________________________________
Permanent Address : ___________________________________
Birthdate : ___________________________________
Program : ___________________________________
Major(s) : ___________________________________
Minor(s) : ___________________________________
Email Address : ___________________________________
Contact No. : ___________________________________
Note: Submit this application form for Graduation in quadruplicate (4 copies) at the Registrar’s Office two weeks
after enrolment for the last term/semester in the University.
cc: Registrar’s Office
Dean’s Office
Adviser
Student