ACADEMICS AND RESEARCH DIVISION

SENIOR HIGHSCHOOL DEPARTMENT

APPLICATION FOR GRADUATION

F – AFG–SHS-001–V1–2021-04-17

Date of Application

Track/Strand

Last Name First Name Middle Name

Date of Birth: Nationality: Gender:

Educational Background

Elementary School: Year Graduated:

Junior High School: Year Graduated:

School Last Attended: School Year:

(Before being admitted to SSC-RdC)

I hereby understand and agree to the following conditions pending approval of this
application for graduation:

a) That all documentary requirements for admission have been completed.

c) That I shall have completed and passed all academic requirements for my degree.
c) That the School Registrar upon final evaluation of the above-mentioned conditions
may DISAPPROVE this application if found deficient.

Conforme:

Signature of Student Over Printed Name Parent/ Guardian Over Printed Name

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Manila-Cavite Road Sta. Cruz, Cavite City (046)431-7011 www.sscr.edu
 List of Deficiencies
(To be filled up by the Principal's Office)

Learner's Reference Number

Form 137 - TOR copy valid to SSCRdc
FORM 138 - JHS Report Card
PSA Birth Certificate
ESC/QVR Certificate for SHS Applicant
Certificate of Good Moral Character
Transfer Credentials for Transferees
ACR & Study Permit (for Aliens) Philippine Passport (for Dual Citizens)
INC/FAILED Subjects:

Please complete AS SOON AS POSSIBLE the deficiencies marked X above.

Failure to do so may merit DISAPPROVAL of this application for graduation.

Strand Head Principal

Vice President for Academic and Research

OFFICE OF THE REGISTRAR

Records Verified by: Date:

Remarks: APPROVED DISSAPPROVED

School Registrar:

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Manila-Cavite Road Sta. Cruz, Cavite City (046)431-7011 www.sscr.edu