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Decalaration Waiver - Transferee

University of Baguio Enrollment Declaration of Waiver

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Joan Ducusin
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7 views

Decalaration Waiver - Transferee

University of Baguio Enrollment Declaration of Waiver

Uploaded by

Joan Ducusin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 3

Reference No.

: QF-ARC-035 Revision No: 01 Effectivity Date: December 1,


2021

LETTER OF DECLARATION AND WAIVER

Transferee - Degree or Non-Degree Program

I, , , of legal age and residing


at
Family Name, First Name, M.I. Nationality
hereby state
that:
Address
1. I wish to apply for admission to the program
(ex: Bachelor of Science in Civil Engineering)
at University of Baguio, Baguio City;

2. Prior to my application, I enrolled at the following schools for the tertiary level with the following
details;

NAME OF SCHOOL ADDRESS OF SCHOOL ACADEMIC YEAR/TERM

3. As of date of this Undertaking, I have not submitted the following admission

document(s)/ record(s) Please put a check mark whichever is applicable:


Original Copy of Transfer Credentials True Copy of Transcript of Records (for
(Honorable Dismissal) – for transferee transferee)
PSA Birth Certificate Marriage Contract (Photocopy) - for
married
Certificate of Good Moral Character female applicant & affidavit to use
married name in all her school records
Others (please specify)
4. I am aware that the aforementioned document(s)/ record(s) is/are requirements for my
acceptance at University of Baguio. I am also aware that I have been provisionally accepted
subject to the condition that the original copies will be submitted to the Admissions and
Records Center within thirty (30) working days from the start of classes during the First
Semester AY 2022-2023 or as may be further prescribed by the office.
5. I understand that if I FAIL to submit the aforementioned credentials, I shall give University of
Baguio the right to cancel my provisional enrollment, withhold the release of all my
credentials/ Transcript of Records/ Diploma, and not demand any credit (unit) of work done nor
will I claim a refund of the amount previously paid for tuition fees and other school fees.
6. I have submitted an authentic and latest available copy of my school records from my last
school attended;
7. Furthermore, I hereby waive any right of action against University of Baguio, its affiliates,
representatives, agents and/ or any of its duly constituted officers / employees that any
misrepresentation or inaccuracy contained in this Form and/or in the event that I will not be
allowed to graduate because of my failure to submit the original copy of the aforementioned
document(s)/record(s) within the given period and/ or meet the above conditions.

By affixing my signature over my name, I hereby expressly agree that I have read the entire
content of this undertaking and I fully understand its nature and purpose, and I agree to be legally
bound by it.

Done this day of , year 20 in the City of Baguio, Philippines.

Student Signature over Printed Name Parent/Guardian Signature over Printed Name

Page 1 of 3
Reference No.: QF-ARC-035 Revision No: 01 Effectivity Date: December 1,
2021

LETTER OF DECLARATION AND WAIVER


Contact No. (Mobile) Contact No. (Mobile)

Email Email

Note: Please attached identification card of Parent/Guardian with signatures.

Page 2 of 3
Reference No.: QF-ARC-035 Revision No: 01 Effectivity Date: December 1,
2021

LETTER OF DECLARATION AND WAIVER

PARENT/GUARDIAN IDENTIFICATION CARD

FRONT

BACK

Page 3 of 3

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