This is the OFFICIAL RECEIPT if it indicates Amount Paid and O.R.
No
UP FORM 5. UNIVERSITY OF THE PHILIPPINES BAGUIO CERTIFICATE OF REGISTRATION
SAIS ID COLLEGE PROGRAM TERM & SY
STUDENT NO. 202006416 NAME: LALAS , LUV DIVINE DECANO Second
10095180 CS BS Physics Semester, 2022-
2023
REGISTRATION STATUS: ACADEMIC CAREER YEAR LEVEL GRADUATING THIS TERM? EMPLOYED? STUDENT HOUSING
Undergraduate 3rd Year
COUNTRY OF CITIZENSHIP RELIGIOUS PREF. SEX CIVIL STATUS PAYMENT DETAILS
Female Single O.R.No Transaction No. Date Amount Paid
CLASS CODE SUBJECT SECTION UNITS SCHEDULE & ROOM LAB FEE Cashier:
1742 PHYSICS TBA 3.00 - lec TBA Register:
182 Mode:
1741 PHYSICS Z 3.00 TTH 04:30PM - 06:00PM lec IB204 Amount:
175 ITEM CODE AMOUNT
1744 PHYSICS R 3.00 WF 04:30PM - 06:00PM lec IB205 Tuition for Academic Courses 17,000.00
199
1705 CHEM A 1.00 WF 07:30AM - 09:00AM lab IB108
NSTP Tuition 0.00
18.1 Admission Fees 0.00
1704 CHEM 18 DP 4.00 WF 01:00PM - 03:00PM lec TBA Entrance Fees 0.00
1739 PHYSICS Q 3.00 WF 03:00PM - 04:30PM lec IB205 Registration Fees 40.00
165 Library Fees 700.00
1536 PE 2 B 2.00 WF 09:30AM - 10:30AM lec HIMNASYO Laboratory Fees 0.00
************************************************ nothing follows ************************************************ Computer Fees 510.00
Athletic Fees 55.00
Cultural Fees 50.00
Medical and Dental Fees 50.00
Guidance Fees 0.00
Handbook Fees 0.00
School ID Fees 8.00
Development Fees 50.00
EDF 0.00
Remaining number of semesters to avail Free Tuition and Other School Fees:
First Time to Signature and Academic Program Constituent Total Tuition 17,000.00
NO Printed Name of Unit/Campus
enroll in UP? Bachelor of Science
Adviser
Term of First in Physics UPBAG/UPBAG
Enrollment
Add: Other School Fees 1,463.00
Total Number of Units: 17.00 Reasons for underloading (if underloaded): Less: Scholarship/Privilege 0.00
Present Address: Tel.No. Less: Tuition Subsidy 17,000.00
Nilombot, Mapandan , PHL 09073091013 Less: Other School Fees Subsidy 1,463.00
Employer's Name and Address Tel No. Less: Loan 0.00
Contact Person in case of emergency Tel No.
AMOUNT PAYABLE 0.00
Address Zip Code:
STUDENT PLEDGE
SCHOLARSHIP /
I hereby certify that all information given above are correct. ST Code:
PRIVILEGES
In consideration of my admission to the UNIVERSITY OF THE PHILIPPINES and of the privileges of a student in
this institution, I hereby promise and pledge to abide by and comply with all the rules and regulations laid down by
competent authority in the University and in the College in which I am enrolled.
Certified By:
Date :__________________________________ Signature of Student: ___________________________________
ASSENT Advised By: acjasmin
Tuition Subsidy
I have read the University of the Philippines' Privacy Notice for Students. and WMOF
I understand that for the UP System to carry out its mandate under the 1987 Constitution, the UP Charter, and WMOF
other laws, that the University must necessarily process my personal and sensitive information. Form 5 issued by: mplabuguen
Therefore, I recognize the authority of the University of the Philippines to process my personal and sensitive
information, pursuant to the UP Privacy Notice and applicable laws
Assessed by:
Signature of Student:_________________ Signature of Parent/Guardian (if student is a minor):__________________
Date Generated: Feb 13, 2023 1:13 PM
