URDANETA CITY
UNIVERSITY
Owned and operated by the City Government of Urdaneta
IMPORTANT NOTICE:
1. If your Legal Name needs to be updated, please report immediately to your College Secretary and Registrars’ office.
2. Please make sure that your final evaluation is attached to this form.
3. Submit the duly accomplished form to your College Secretary.
4. Revocation of your application is allowed if the records provided to fill this form is proven fraudulent.
APPLICATION FOR GRADUATION
Date: March 27, 2023
THE PRESIDENT
Urdaneta City University
San Vicente West, Urdaneta City Pangasinan
Thru: THE REGISTRAR
Dear Sir:
I have the honor to apply for graduation and have my name included in the list of graduates for the 2nd semester, A.Y. 2022-2023 for the Degree/Diploma
in/of Bachelor of Science in Tourism Management.
Respectfully yours,
JEROME C. CARIG
Signature over Printed Name
Honors and Awards (if any)
Graduating with honors? Yes
No GWA:__________
Not Sure
Degree/Title: Bachelor of Science Major: Tourism Management
PERSONAL INFORMATION:
Last Name First Name Middle Name
CARIG JEROME COLLADO
Permanent Address: #16 ZONE 4, LOMBOY, VILLASIS, PANGASINAN Tel. No.:
Mobile No.: 09669677458
Birthdate: APRIL 20, 2001
Student ID Number: 20193372 Civil Status: SINGLE Sex: MALE Birthplace: URDANETA CITY
PARENTS/GUARDIAN INFORMATION:
Father: GERARDO A. CARIG Mother: JANET C. CARIG
Parent’s Address: #16 ZONE 4, LOMBOY, VILLASIS, PANGASINAN
Guardian: JANET C. CARIG Relationship: MOTHER
Guardian’s Address: #16 ZONE 4, LOMBOY, VILLASIS, PANGASINAN
SCHOLASTICS RECORD:
Primary Completed at: (Grade 1-3) BIBLE METHODIST CHRISTIAN ACADEMY Year Graduated: 2009
Intermediate Completed at: (Grade 4-6) VILLASIS CENTRAL SCHOOL Year Graduated: 2013
High School: Year Graduated:
Junior High School DON RAMON E. COSTALES MEMORIAL NATIONAL HIGH SCHOOL Year Graduated: 2017
Senior High School DON RAMON E. COSTALES MEMORIAL NATIONAL HIGH SCHOOL Year Graduated: 2019
College: URDANETA CITY UNIVERSITY Year Graduated: 2023
Post Baccalaureate: Year Graduated:
Post Graduate: Year Graduated:
For Transferee: (Last School Attended) _______________________________________________________________________________
(Course) ________________________________________________________________ (Year) ________________
FOR GRADUATE SCHOOL STUDENTS ONLY:
Comprehensive Examination: Date of Examination: Rating:
Dissertation/Thesis Title:
CREDENTIALS ON FILE: (to be check by the College Secretary)
_____1. Form 137a/ Form 138
_____2. Certificate of Good Moral Checked by: _____________________________
_____3. PSA Birth Certificate College Secretary
_____4. Barangay Clearance Noted:
_____5. Picture with nametag (passport size) _____________________________
_____6. Medical Certificate College Dean
_____7. Transfer Credential (OTR/Hon. Dismissal)
_____8. Marriage Certificate ____________________________
_____9. Others; ________________________________ Registrar
Bright future starts here (075) 204-9020
San Vicente West, Urdaneta City, Pangasinan
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