U-Go Scholarship

CERTIFICATION FROM SCHOOL REGISTRAR

Kindly accomplish this form and upload/attach the scanned copy to your application form.

Name of the Applicant:

School:

COURSE INFORMATION
Course/ Major

Department/College

Year Level Course Duration

☐ 1st year ☐ 3rd year ☐ 5th year ☐ 3-year course ☐ 5-year course
☐ 2nd year ☐ 4th year ☐ 4-year course ☐ 6-year course

Academic Term Year Graduating

☐ Trimestral ☐ Semestral
☐ Quarter ☐ Others:
Did the student complete a course prior to this one, in this school or in another school?
☐ No ☐ Yes, (please write the school and course)

Did the student receive any disciplinary action?

☐ No ☐ Yes, (type of offense)

ACADEMIC INFORMATION
Cumulative Grade Point Average: Highest Possible Grade Point Average:
Does the student have a failing mark? ☐ Yes How many subjects? ☐ No

I certify that the abovementioned information are true and correct. I am aware that any or all the information furnished
here may be checked against the original documents. Withholding or giving false information will disqualify the applicant
from further assistance by Ayala Foundation.

By affixing my signature in this document, I am giving Ayala Foundation the permission to use any of the above
information for legitimate, program-related purposes only.

Registrar’s Name and Signature Date

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