Reference No.: BatStateU-FO-REG-10 Effectivity Date: May 18, 2022 Revision No.
: 02
APPLICATION FOR GRADUATION
STUDENT INFORMATION
SURNAME: FIRST NAME: MIDDLE NAME: EXTENSION NAME:
(if applicable)
DELA CRUZ JUAN DE LOS SANTOS
BIRTHDATE:
SR CODE: 21-32172 12/31/2004 PLACE OF BIRTH: LIPA CITY, BATANGAS
(MM/DD/YYYY)
HOME ADDRESS: ZIP CODE: 4217
123 A. TANCO DR. BRGY. MARAWOY, LIPA CITY, CONTACT NUMBER: 0912-345-6789
BATANGAS
EMAIL ADDRESS: abc@[Link]
SECONDARY SCHOOL YEAR
LCC SILVERCREST 2021
GRADUATED: GRADUATED:
ELEMENTARY SCHOOL YEAR
TM KALAW MEMORIAL SCHOOL 2015
GRADUATED: GRADUATED:
DATE OF GRADUATION: ☐ DECEMBER, 20____ ☒ MAY, 2025 ☐ MIDTERM, 20____
COLLEGE: COLLEGE OF ACCOUNTANCY, BUSINESS AND ECONOMICS
PROGRAM: BACHELOR OF SCIENCE IN BUSINESS ADMINISTRATION
MAJOR: MAJOR IN MARKETING MANAGEMENT
Requested by: Evaluated by:
JUAN D. DELA CRUZ ____________________________________
Signature over Printed Name of Student Signature over Printed Name of Registrar’s Staff
Date Signed: Date Signed:
Reviewed by: Approved by:
Dr. MONETTE M. SOQUIAT Ms. JENELYN M. GUTIERREZ
Signature over Printed Name of College Dean/ Signature over Printed Name of Authorized Official
Head, Academic Affairs Designation: Head, Registration Services
Date Signed: Date Signed:
DATA PRIVACY AGREEMENT:
☒ In submitting this form, I agree that my details be utilized for evaluating my academic records and for other purposes
relevant to my graduation. I also agree that the information I have indicated in this form be made available to the university,
and to other external agencies, groups and individuals for scholastic, research and employment purposes.
JUAN D. DELA CRUZ
Signature over Printed Name of Student
REMINDER: It is understood that should this application be approved, the candidate MUST COMPLY WITH ALL THE
REQUIREMENTS FOR GRADUATION before the Academic Council Meeting such as:
Photocopy of the Approval Sheet of Thesis/Dissertation
Certificate of Submission of hardbound copy of thesis in the Library
PROCEDURE
Secure and fill-out completely the Application for Graduation Form.
Go to the Registrar’s Office for Evaluation.
Proceed to your Dean’s Office for the review of the application.
Submit the application form to the Registrar’s Office.
Wait for the confirmation of the Registrar’s Office regarding the status of application.
After the confirmation, pay the required fees.
Submit to the Registrar’s Office the receipt of payment for recording.