Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

OFFICE OF THE VICE PRESIDENT FOR ACADEMIC AFFAIRS
COLLEGE OF ENGINEERING
DEPARTMENT OF ELECTRICAL ENGINEERING

REQUEST FOR ADDITIONAL SUBJECT/S

_______ Semester, S.Y. 20___ - 20____

FOR STUDENT USE DATE:____________________

NAME ___________________________________ YEAR LEVEL _____________ COURSE_____________

GENERAL WEIGHTED AVERAGE_____________

No. of Units No. of Hours

Maximum Number of Units Allowed per Curriculum
Currently Enrolled Units
Number of Units to be Added
Number of Overload Units
TOTAL

SUBJECT/S TO BE ADDED
(If the maximum number of units has not been reached yet)
Course Course Description No. of No. of
Code Units Hours

TOTAL

OVERLOAD SUBJECT/S
(Load beyond the maximum number of units allowed)
Course Course Description No. of No. of
Code Units Hours

TOTAL

Attached herewith are my SIS SUBJECT EVALUATION/ CURRICULUM & CERTIFICATION OF GRADES for reference.

_______________________________
(Signature over Printed Name)
FOR COLLEGE USE

WE CERTIFY THAT WE HAVE PROPERLY EVALUATED THE CURRICULUM AND THE GRADES OF THE
STUDENT. WE FURTHER CERTIFY THAT THE REQUEST IS IN ACCORDANCE WITH THE POLICY ON OVERLOAD
SUBJECT. BASED ON OUR EVALUATION THE STUDENT IS:

Graduating this Semester Non-Graduating Deloaded (with W / Drp / Failed last Sem Enrolment

RECOMMENDING APPROVAL:

_______________________________ ____________________________________
(Name & Signature of the Department Chaiperson) (Name & Signature of the College Dean)

FOR COLLEGE USE

ACTION TAKEN: Approved Disapproved

DR. MANUEL M. MUHI

Vice President for Academic Affairs

PUP NDC Campus Anonas Street, Sta. Mesa, Manila Phone: (Direct Line): 7166273
website: www.pup.edu.ph e-mail: ce@pup.edu.ph

“ HE OUNTRY’S OLYTECHNIC ”