CENTRAL LUZON STATE UNIVERSITY

Science City of Munoz, Nueva Ecija

OFFICE OF ADMISSION
2nd Semester SY 2014-2015

Preliminary
Assessment Form
Student's Copy

REG_CODE 142850913
ID_NO 13-8509
STUD_TYPE Old
NAME MATIAS, Annamarie S.
STATUS Reg
COLLEGE CED AGE 19
CURR_YR BSED2-3 ENGL GENDER Female
SCODE

CAT_NO

1
3252
ENGL 115
2
3253
EDUC 120
3
3255
EDUC 120 LAB B
4
3256
PE 115
5
3257
SOCSCI 100
6
3258
EDUC 115
7
3259
FLDS 105
8
3260
ENGL 230
9
3261
ENGL 240
10
3262
ENGL 250
11
3263
HUMAN 100
12
13
14
15
16
Scholarship None
Remarks
ASSESSMENT
TO PAY
General Fund
Entrance Fee
0.00
Tuition Fee
4347.00
Laboratory Fee
200.00
Miscellaneous Fund
Registration
100.00
Medical & Dental
200.00
Athletic
100.00
Audio-Visual
100.00
Trust Fund
Library
200.00
Recreation
60.00
Charity
50.00
Scientific Journal
45.00
SCUAA III
115.00
Guidance Counseling
50.00
Parents Association
30.00
Insurance
0.00
USSC-SNO
Class Organization
20.00
Student News Organ
22.50
Development Fee
IGS Journal
Bridging Fee
HRM Enhancement Fee
ID
NSTP
Computer Lab Fee
OSA Foreign Student Fee
Non-citizenship Fee
GEDF
Late Registration Fee
IT Practicum
ICT Fee
Field Study Fee
Practice Teaching Fee
Maintenance Fee
TOTAL

UNITS
3
2
1
2
3
3
1
3
3
3
3

Total Units 27
TOTAL
4547.00

BILLING

TOTAL
0.00

0.00
0.00
0.00
500.00

0.00
0.00
0.00
0.00
0.00

550.00

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

42.50

0.00
0.00
0.00

500.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
500.00
0.00
250.00

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

6889.50

0.00

Annamarie S. Matias
Student Signature
* NOT OFFICIALY ENROLLED --- -- --- -- --- -- --- -- Printed on 2014-Oct-30 12:06