RO Form 2

Republic of the Philippines October 22, 2012

CEBU TECHNOLOGICAL UNIVERSITY Revision 2

Danao Campus
Sabang, Danao City, Cebu

REGISTRATION FORM

STUDENT PERSONAL DATA: Date: August 12, 2021

Recla Jann Rey Belasis

( Last Name ) ( First Name ) ( Middle Name )

Home Address: Limogmog, Curva 2, San Vicente, Yati, Liloan, Cebu Telephone No: 09665428405
Congressional District: 0 5 City Address: Liloan E-mail Address: jannrey.recla@ctu.edu.ph
Gender: [ ✔]Male [ ]Female Birthday: (mm/dd/yyyy) 08/16/01 Birthplace: Cebu City
Citizenship:Filipino Religion: Roman Catholic Civil Status: [✔ ]Single [ ] Married [ ] Separated [ ] Widow/er
Father's Name: Dionisio Y. Recla Occupation: Vendor
Mother's Name:Ma. Jezel B. Recla Occupation: Vendor
Guardian's Name:Ma. Jezel B. Recla Contact Number: 09393146165
Educational Background: Name of School Academic Year Honors Received
Elementary: Camp Lapu-Lapu Elementary School 2013-2014 None
High School: Apas Integrated Senior High School 2017-2018 Top 24
College: Cebu Technological University Danao Campus
ENROLLMENT DOCUMENTS SUBMITTED (for NEW and TRANSFEREE student only)
[ ] DepEd Form 138 /Report Card [ ] Birth Certificate from NSO [ ] Certificate of Good Moral
[ ] Certificate of Transfer Credentials & TOR [ ] Marriage Certificate if applicable
" I hereby certify that all entries are true and correct. I do solemnly swear to abide with the laws, policies,
rules and regulations set forth by the University."

Student's Signature over Printed Name

STUDENT LOAD:
ID Number: 3 2 0 0 7 9 8 Course:BSTM Major:Tourism Management
Year Level: 2
School Year:2021-2022 Semester: [ ✔] 1st [ ] 2nd [ ] Summer Term Enrolment Status: [ ✔ ] Regular [ ] Irregular
Student Status: [ ] New [ ] Old [ ] Transferee [ ] Returnee [ ] Shiftee [ ] Cross Enrollee
BLOCK SECTION:
MIS Code Course Code Descriptive Title Time Days Room Units

EVALUATED BY:
College Dean/ Enrollment Committee: Evaluation date: Total Units:

APPROVED BY:
MEDICAL CLINIC MIS OFFICE CASHIER'S OFFICE
( Physical Examination ) (Encoding of Class Schedules (Payment of School fees)
Assessment of Student Load)

______________________ ______________________ __________________

School Physician/Nurse System's Operator Cashier

NSTP PTA Office REGISTRAR'S OFFICE

( Enlistment for those who will (Payment of membership/special project/group accident insurance) (Submission of registration form and credentials

be taking CWTS OR ROTC) Printing of Certificate of Registration)

_____________________
Coordinator PTA Officer Registrar