APPLICATION PERMIT (AY 2022-2023)

Name: LACANG, JEANINA ANNE

______________________________________________________________________
Surname First Name Middle Name

Grade Level: FRESHMAN Gender: FEMALE

Intended Academic Program:

Bachelor of Science in Nursing (BSN)

Last School Attended:

Colegio De Santa Philomena

Applicant No. #165958

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Signature of Admission Officer
This is an auto-generated copy of your application permit. Only the applicant whose name appears in this permit has the right to use it for the applying term.
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WAIVER FOR CREDENTIAL

To Whom It May Concern:

May I request your good office to please allow me to enroll even without my

( ) Grade 12 (Report Card) ( ) For Passers of Philippine Educational Placement Test (PEPT) and
( ) Certificate of Good Moral Character Alternative Learning System Accreditation and Equivalency (ALS
( ) PSA-authenticated Birth Certificate A&E), Certificate of Rating
( ) 2 X 2 colored ID Picture ( ) For ALS A&E passers, Diploma
( ) Form 137 ( ) For graduates of 2015 and below, Form 138 (Report Card)
( ) For Passers of Philippine Educational Placement Test (PEPT) and ( ) others ________________________
Alternative Learning System Accreditation and Equivalency (ALS
A&E), Certificate of Passing

because ________________________________________________________________________________.

I promise to submit my credential / s on or before __________________. I understand that failure to submit my credential / s
on the said date will automatically forfeit my enrollment in the University without any refund. I also understand that release of
my transfer credentials will depend on my full payment of any remaining balance due the university.

Respectfully yours,

Lacang, Jeanina Anne

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Printed Name & Signature of the Student
ADDRESS: BLK 6 LOT 12 BATIKULIN STREET,
Dulong Bayan, Bacoor, Cavite
CONTACT #: (09) 17376-1861

For questions and concerns regarding your NU application, please contact the Admissions Office of the NU branch where
you applied.

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