Document Title Program Status Conversion Form

Document Type TD- PC-LUCs

Version 01-2025

Page 1

I. LUC PROFILE

Local University/ College (LUC):

President:
Date of Evaluation:

Program for Conversion:

II. PROGRAM EVALUATION

REMARKS
HIGHEST EDUCATIONAL
AREA/S FOR EVALUATION NAME (Partially Complied / Complied /
QUALIFICATION
Not Complied)
1. Dean (if applicable)

2. Program Chair

3. Faculty (Core/ Professional

Courses ONLY)

a. Full-time
(add additional rows if needed)

b. Part-time
(add additional rows if needed)
 Document Title Program Status Conversion Form

Document Type TD- PC-LUCs

Version 01-2025

Page 2

Professional Laboratories REMARKS

AREAS FOR EVALUATION
(if applicable) (Partially Complied / Complied / Not Complied)
4. Facilities (e.g. Computer Laboratory, Science Laboratory, EdTech Room,
(add additional rows if needed) Business Incubation Laboratory, Mock up Travel Counter, Kitchen
Laboratory, etc.)
 Document Title Program Status Conversion Form

Document Type TD- PC-LUCs

Version 01-2025

Page 3

AREAS FOR EVALUATION Actual Condition/s Remarks Recommendations

5. Support Services

a. Guidance &
Counselling

b. Guidance Programs &

Activities

c. Guidance Counselor
(qualifications and
license)
6. Library

a. Librarian

b. Library Holdings
7. Others
 Document Title Program Status Conversion Form

Document Type TD- PC-LUCs

Version 01-2025

Page 4

III. Documents Needed

 Matrix List of Faculty Members

 Teaching Loads for 2nd Semester SY 2024-2025
 Credentials of Dean/ Program Chair, Faculty, Guidance Counselor, and Librarian
 Contracts/ Appointment Papers
 Guidance Programs

EVALUATED BY:
(Name and Signature)
Designation