UNIVERSITY OF THE PHILIPPINES

OPEN UNIVERSITY
UP FORM 5 CERTIFICATE OF REGISTRATION

STUDENT NO. NAME FACULTY PROGRAM/MAJOR LOCATION

FICS FMDS LOCAL
FED FICS OFFSHORE
TERM AND AY ___________ ACADEMIC CAREER YEAR LEVEL GRADUATING THIS EMPLOYED?
1ST 3RD UNDERGRAD GRADUATE CERTIFICATE TERM?
2ND MIDYR NON DEGREE CROSS ENROLEE ___________ YES NO YES NO
COUNTRY OF CITIZENSHIP RELIGIOUS PREF SEX at BIRTH CIVIL STATUS PAYMENT DETAILS
OR NO. DATE:
TRANSACTION NO. AMOUNT PAID:
COURSE/SUBJECT UNIT ITEM AMOUNT
Tuition Fee
Reg Fee
Misc Fees
Inst Materials Fee
ID Fee
Entrance
Deposit
Other Fee
TOTAL NUMBER OF UNITS
TOTAL FEES
********Nothing Follows********
PHILIPPINE HOME ADDRESS Less: Scholarship/Privilege
TEL NO. EMAIL: Less: Socialized Tuition
PHILIPPINE OFFICE ADDRESS Less: Waiver of Other School Fees
TEL NO. EMAIL: Less: Tuition Subsidy
FOREIGN HOME ADDRESS. Less: Loan
TEL NO. EMAIL:
FOREIGN OFFICE ADDRESS.
AMOUNT PAYABLE:
TEL NO. EMAIL:
STUDENT PLEDGE:
I hereby that all information given above are correct in consideration of my admission to the UNIVERSITY OF THE PHILIPPINES and of the
privileges of a student in this institution. I hereby promise pledge to abide and comply with all the rules and regulations laid down by competent
authority in the UNIVERSITY enrolled in the College which I am enrolled.
Date: Signature:

UNIVERSITY OF THE PHILIPPINES

OPEN UNIVERSITY
UP FORM 5 CERTIFICATE OF REGISTRATION

STUDENT NO. NAME FACULTY PROGRAM/MAJOR LOCATION

FICS FMDS LOCAL
FED FICS OFFSHORE
TERM AND AY ___________ ACADEMIC CAREER YEAR LEVEL GRADUATING THIS EMPLOYED?
1ST 3RD UNDERGRAD GRADUATE CERTIFICATE TERM?
2ND MIDYR NON DEGREE CROSS ENROLEE ___________ YES NO YES NO
COUNTRY OF CITIZENSHIP RELIGIOUS PREF SEX at BIRTH CIVIL STATUS PAYMENT DETAILS
OR NO. DATE:
TRANSACTION NO. AMOUNT PAID:
COURSE/SUBJECT UNIT ITEM AMOUNT
Tuition Fee
Reg Fee
Misc Fees
Inst Materials Fee
ID Fee
Entrance
Deposit
Other Fee
TOTAL NUMBER OF UNITS
TOTAL FEES
********Nothing Follows********
PHILIPPINE HOME ADDRESS Less: Scholarship/Privilege
TEL NO. EMAIL: Less: Socialized Tuition
PHILIPPINE OFFICE ADDRESS Less: Waiver of Other School Fees
TEL NO. EMAIL: Less: Tuition Subsidy
FOREIGN HOME ADDRESS. Less: Loan
TEL NO. EMAIL:
FOREIGN OFFICE ADDRESS.
AMOUNT PAYABLE:
TEL NO. EMAIL:
STUDENT PLEDGE:
I hereby that all information given above are correct in consideration of my admission to the UNIVERSITY OF THE PHILIPPINES and of the
privileges of a student in this institution. I hereby promise pledge to abide and comply with all the rules and regulations laid down by competent
authority in the UNIVERSITY enrolled in the College which I am enrolled.
Date: Signature: