OFFICE OF THE COLLEGE
AFG.FORM B
Initao REGISTRAR
P2, Jampason, Initao, Misamis Oriental
College : +63955 649 5141
AFG.FORM A
APPLICATION FOR GRADUATION
Date: ___________________ Document Checklist
Program Dean
The College Registrar [ ] Tree Planting Certificate
Initao College [ ] Internship Portfolio
[ ] Notarized Internship Certificate
Jampason, Initao, Misamis Oriental
[ ] Notarized FS1 and FS2 Certificate(for
BEED)
Through: _______________________ [ ] Internship Fee Receipt
Program Dean [ ] Clearance
Registrar
Ma’am: [ ]
Clearance
[ ]
Receipt for SO Application
I have the honor to apply for graduation [ ]
Form 137
S.Y._________________ [ ]
TOR Granted Transfer Credential
for the degree of (for transferees)
[ ] Photocopy of Research & Feasibility
______________________________________ Study
major in _____________________________________. Approval Sheet (with signed library
stamp)
[ ] Notarized Internship Certificate
Very truly yours, (with signed Program stamp at the
back)
_____________________________ ___________________ [ ] Notarized FS1 and FS2 Certificate(for
BEED)
Name & Signature of Student Student
(with signed Program stamp at the
Number back)
A. Title of [ ] Thesis [ ]Case Study [ ] Feasibility Study [ ] Field Practice []
Narrative Report
____________________________________________ _____________________________________________
Name and Signature of Thesis/FS Adviser Name and Signature School Librarian
B. Practicum Details
HTE Name
HTE Address
Date of Completion/Expected Completion
______________________________________________
Name and Signature of Practicum Coordinator
C. Subject/s enrolled this (current) semester:
Course Code and Description Units Instructor’s
Initial
Total
Approved by:
______________________________________________ MA. IVONNE MAE V. MAGHANOY
Name and Signature of Program Dean College Registrar
ELIEDA L. APOR, MAED GRACE C. LAPINIG, Ph. D
Vice President for Academic Affairs College President
Note: Provide 1 copy for the Registrar, 1 Copy for
the Dean’s Office, 1 Received Copy)
PERSONAL DATA SHEET OF APPLICANT FOR GRADUATION
(Please print all entries in CAPITAL LETTERS)
Student Number: ________________
Name (Family Name, First Name, Middle Name):
_______________________________________________________
If you are a married woman, write your maiden name:_____________________________________
Age: ______ Sex:___________ Religion: ______________________ Citizenship:
____________________
Date of Birth: ______________ Place of Birth: _________________ Civil Status: ____________________
Contact No.: ____________________________
Home Address (Barangay/Street, Town/City, Province)
_________________________________________________________________________________________
Name of Father: _________________________Citizenship:_____________Occupation:___________
Name of Mother: _________________________Citizenship:_____________Occupation:___________
Parent’s Address: _______________________________________________________________________
If Married, Spouse(husband/wife) Name: ______________________Occupation: _____________
Spouse Address:________________________________________________________________________
SCHOOL RECORDS
Honors or
School
Name of School Address Distinctions
Year
Received
Primary
Secondary
Senior High
School
Tertiary: 1st Year
2nd Year
3rd Year
4th Year
5th Year
6th Year
Membership in Organizations: ___________________________________________________________________
I swear that all entries contained in this application for graduation are true and correct to the
best of my knowledge and belief.
______________________________________________ ____________________
Name and Signature of Applicant Date
OFFICE OF THE
REGISTRAR
the Dean’s Office, 1 Received Copy)
Initao
Note: Provide 1 copy for the Registrar, 1 Copy for
P2, Jampason, Initao, Misamis Oriental
: 088-8820862
College : +63955 649 5141
DATA PRIVACY CONSENT FORM
AFG.FORM C
I am allowing Initao College to publish my name as a candidate for graduation for scrutiny
of the public. I also allow the College to publish ( printed or online ) the degree I earned including
any honors received, (as well as any previous degrees earned), in the program to be distributed
during the commencement exercises. I understand that the College is seeking my consent as the
graduation program may be accessed by members of the public.
I further confirm that Initao College, through its appropriate offices, is authorized to
provide my name, degree(s) and honor(s) earned, contact information as well as such other
personal information that will enable my identity to be verified, to the Alumni Office and
Association so as to enable Initao College to comply with R.A. 9500.
______________________________________________ ____________________
Name and Signature of Student Date
Note: Provide 1 copy for the Registrar, 1 Copy for
the Dean’s Office, 1 Received Copy)
