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2 REPUBLIC OF THE PHILIPPINES 2

3 POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
ENDORSEMENT FORM 3
4 SANTA ROSA CAMPUS OF SHIFTEE/RETURNEE FOR ENCODING 4
5 TO THE SIS 5
6 ALL FIELDS MUST BE FILLED-UP PROPERLY. INCOMPLETE INFORMATION WILL NOT BE PROCESSED. ONE ENDORSEMENT FORM PER STUDENT ONLY. 6
7 ACCOUNT INFORMATION 7
8 DATE: 7/22/2019 16:06:20 CONTROL NO: 8
9 STUDENT NUMBER: 2003-00003-SR-0 9
10 FIRST NAME: NO RECORD FOUND!, CLICK HERE TO CREATE ACCOUNT 10
DOCUMENTS /
11 MIDDLE NAME: NO RECORD FOUND!, CLICK HERE TO CREATE ACCOUNT 11
CREDENTIALS N/A
12 LAST NAME: NO RECORD FOUND!, CLICK HERE TO CREATE ACCOUNT SUBMITTED: 12
13 NAME SUFFIX: 13
14 GENDER: NO RECORD FOUND!, CLICK HERE TO CREATE ACCOUNT 14
15 LANDLINE AND MOBILE HAS AN SIS ACCOUNT 15
YES
16 NUMBER:
DATE OF BIRTH: ALREADY? 16
17 E-MAIL ADDRESS: NO RECORD FOUND!, CLICK HERE TO CREATE ACCOUNT 17
18 NATIONALITY: 18
19 CIVIL STATUS: PERMANENT ADDRESS: 19
20 NAME OF GUARDIAN: 20
21 GUARDIAN’S CONTACT 21
22 NUMBER: ACADEMIC INFORMATION 22
23 PREVIOUS COURSE, YEAR AND SECTION: 23
24 SCHOOL/UNIVERSITY: SY, SEMESTER (RE) 24
25 ADMITTED
CURRICULUM YEAR 25
PREVIOUS
26 TO BE USED: 26
COLLEGE/COURSE:
27 27
RE-ADMISSION STATUS:
28 ENROLLED FROM: 28
29 ENROLLED TO: NSTP: 29
30 SUBJECT(S) TAKEN SUBJECT(S) EQUIVALENT TO 30
31 SUBJECT NO. OF FINAL SUBJECT NO. OF 31
SUBJECT TITLE SY SEM SUBJECT TITLE
32 CODE UNITS GRADE CODE UNITS 32
33 CWTS 1013 CWTS/ROTC 1 3 2018-19 FIRST 2.75 ACCO 2013 Basic Financial Accounting Part 1 3 33

34 34
35 35
36 36
37 TOTAL UNITS 3 TOTAL UNIS 3 37
38 THIS IS TO CERTIFY AND ENDORSE THE FINAL GRADES IN THE FOLLOWING SUBJECTS TAKEN BY THE STUDENT IN THE PREVIOUS SEMESTER IN PUP. 38
39 SUBJECT NO. OF FINAL 39
SUBJECT TITLE DAYS TIME SY SEM
40 CODE UNITS GRADE 40
41 CWTS 1013 CWTS/ROTC 1 3 MON 7:30-10:30 2018-19 FIRST 2.75 41
42 42
43 43
44 44
45 45
46 RESPECTFULLY SUBMITTING THIS OFFICIAL DOCUMENT TO THE PUP ICT CENTER TO PROCESS A TRANSFEREE/RETURNEE WHO WAS OFFICIALLY INSTRUCTIONS 46
47 ADMITTED/RE-ADMITTED PER UNIVERSITY POLICY ON TRANSFEREE/RETURNEE FOR INCLUSION AND ENCODING OF ACADEMIC RECORDS IN THE 1.    Fill-up form properly 47
48 PUP STUDENT INFORMATION SYSTEM (SIS). I HEREBY CERTIFY THAT THE INFORMATION INDICATED IN THIS DOCUMENT ARE TRUE AND CORRECT, 2.    Ensure correctness of data 48
49 BASED ON THE OFFICIAL RECORDS SUBMITTED TO OUR OFFICE. 3.    Print (8.5” x 13.0” bond
49
paper)
50 FOR SIS CAMPUS ADMIN 50
4.    Sign/Affix valid signature
51 5.    Scan document (JPG, 300dpi) 51
52 Approved by: CHARITO A. MONTEMAYOR 6.    Attach JPG and send email to 52
53 Campus Director your SIS Campus Admin 53
7.    Keep printed copy for records-
keeping
 paper)
4.    Sign/Affix valid signature
5.    Scan document (JPG, 300dpi)
6.    Attach JPG and send email to
your SIS Campus Admin
54 7.    Keep printed copy for records- 54
keeping
55 55
56 Acknowledged by: TERESITA Z. BAUTISTA 56
57 Campus Registrar 57
58 58
 SEARCH STUDENT NO HERE: 2003

SELECT STUDENT NUMBER: 2003-00003-SR-0 [1] NO RECORD FOUND!, CLICK HERE TO CREATE ACCOUNT
FIRST NAME: NO RECORD FOUND!, CLICK HERE TO CREATE ACCOUNT
MIDDLE NAME: NO RECORD FOUND!, CLICK HERE TO CREATE ACCOUNT
LAST NAME: NO RECORD FOUND!, CLICK HERE TO CREATE ACCOUNT
NAME SUFFIX: {{fill out}}
GENDER: NO RECORD FOUND!, CLICK HERE TO CREATE ACCOUNT
LANDLINE AND MOBILE NUMBER: {{fill out}}

DATE OF BIRTH: {{fill out}}

E-MAIL ADDRESS: NO RECORD FOUND!, CLICK HERE TO CREATE ACCOUNT
NATIONALITY: {{fill out}}
CIVIL STATUS: {{fill out}}
NAME OF GUARDIAN: {{fill out}}
GUARDIAN’S CONTACT NUMBER: {{fill out}}

PERMANENT ADDRESS {{fill out}}

COURSE, YEAR AND SECTION: {{fill out}}

SUBJECT(S) TAKEN SUBJECT(S) EQUIVALENT TO

SUBJECT CODE SUBJECT TITLE NO. OF UNITS DAYS TIME SY SEM FINAL GRADE SUBJECT CODE SUBJECT TITLE NO. OF UNITS
CWTS 1013 CWTS/ROTC 1 3 MON 7:30-10:30 2018-19 FIRST 2.75 ACCO 2013 Basic Financial Accounting Part 1 3
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