Request For TOR NEW

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RepublicofthePhilippines

BATANGASSTATEUNIVERSITY
TheNationalEngineeringUniversity
ARASOF-Nasugbu
R.MartinezSt.,Brgy.Bucana,Nasugbu,Batangas
TelNos.:(+6343)4160349 loc.114 /+63919 0790672
EmailAddress:registrar.nasugbu@g.batstate-u.edu.ph|WebsiteAddress:http://www.batstate-u.edu.ph

OfficeofTheRegistrar
August 25, 2022

Sir/Madam:

GreetingsfromBatStateUARASOF-Nasugbu!

WehavereceivedyourrequestfortheissuanceofyourTranscriptofRecords(TOR).

Inordertoprocessyourrequest,kindlyfilloutcompletelytheattachedformandsubmittherequireddocumentsto ensurethe
processingof yourrequest.

We will update you on the status of your request and will notify you of your schedule for pick-up. In
lightof the COVID-19 public health situation issued by the Philippine government, please be informed
that wearetakingthe necessaryprecautionarymeasuresforthesafetyof everyone.

Kindlypreparethefollowingdocumentsreadywithyouwhenyouarescheduledtopick-
upyourdocumentsbyappointment:
1. OriginalCopyof Student Clearance(pleasecoordinatewithyourcollege);
2. Two(2)piecesof documentarystamps; and
3. Payment.

In case you will not be able to personally appear, kindly designate a representative and have them
presenta valid ID, an authorization letter, and your school/valid ID or Special Power of Attorney (SPA)
for thoselivingin other countries.

Shouldyouhavefurtherconcerns/questions,donothesitatetocontactusat0919-079-0672/(043)416-03-
50local114or send usa message viaemailatregistrar.nasugbu@g.batstate-u.edu.ph.

Thankyouand staysafeand healthy.Godbless!

Trulyyours,

ERWINR. ABIAD
RegistrarIII/
Head,RegistrationOffice

LeadingInnovations,TransformingLives
RepublicofthePhilippines
BATANGASSTATEUNIVERSITY
TheNationalEngineeringUniversity
ARASOF-Nasugbu
R.MartinezSt.,Brgy.Bucana,Nasugbu,Batangas
TelNos.:(+6343)4160349 loc.114 /+63919 0790672
EmailAddress:registrar.nasugbu@g.batstate-u.edu.ph|WebsiteAddress:http://www.batstate-u.edu.ph

OfficeofTheRegistrar
PERSONAL INFORMATION FORM FOR
THEREQUESTOFTRANSCRIPTOF RECORDS(TOR)
Kindlyfillouttheformcompletely,andforwardittoouremailaddresstogetherwiththerequireddocumentstofacili
tateyour request.

PURPOSEOFREQUEST: EMPLOYMENT
(Employment,Evaluation,BoardExamination,otherpls.specify:)
SRCode/StudentNumber: 15-85316

Program/Course: BS in Hospitality Management

Honors/Distinction(College): CABEIHM

DateofGraduation (ifapplicable): AUGUST 12, 2022

CompleteName(LastName,FirstNameMiddleName): BRUCAL, CLODE AURRELL SALAYSAY

CompleteAddress: brucalclode@gmail.com

ContactNumber: 09998409268

Date ofBirth(Based onNSO/PSA): MARCH 13, 1999

PlaceofBirth(Basedon NSO/PSA): LUMBANGAN NASUGBU BATANGAS

CompleteNameofSecondary School(Graduated): ADELAIDO A. BAYOT MEMORIAL SCHOOL INC

CompleteAddressofSecondary School(Graduated): J.P LAUREL STREET NASUGBU BATANGAS

DateofGraduation: MARCH 2015

IfTransferee,CompleteNameofSchool: NA

CompleteAddressofSchool: NA

UnderK-12 program:

CompleteNameofJuniorHighSchool: NA

DateofGraduation: NA

CompleteNameofSeniorHighSchool: NA

CompleteAddressofSeniorHighSchool: NA

DateofGraduation: NA

Note:Isthisyourfirst requestforTranscript of Records (TOR)?


_✓_IF Yes, please provide us the scanned copy of the ff:Birth Certificate (PSA/NSO), Marriage
Contact(ifmarried) andStudentClearanceand 2x2picture (GraduationorAny formal)fortheTOR

IF No, please provide us the scanned copy of the ff: TOR, Birth Certificate (PSA/NSO,
MarriageContact(if married)and2x2picture (GraduationorAny formal)fortheTOR

Preparedby: Received bytheRegistrationStaff: DateofRequestApproval

CLODE AURRELL S. BRUCAL


SignatureOverPrintedName SignatureOverPrintedName APRIL 29, 2023

LeadingInnovations,TransformingLives

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