ADAMSON UNIVERSITY 2x2 Picture

900 San Marcelino Street, Ermita White Background

Manila 1000, Philippines (Business Attire)
Office of the Registrar

Click yellow box to insert 2X2 Picture

Student Number

APPLICATION FOR CANDIDACY

FOR GRADUATION
*This is to inform you that upon signing on this document you hereby provide your consent to ADAMSON UNIVERSITY (“AdU”),
to process your personal data for the purpose of documentation and accreditation evidence. The Personal Data, including pic-
tures, collected herein will only be used for the purpose stated above and will be stored and eventually be disposed securely in
accordance to AdU’s retention and disposal policies.

Completely fill up this form legibly:

_____________________ _________________________________________ ________________________

Expected to Graduate Degree / Title Applied for Major
(Term / Semester)

Complete Name
(Please print): _____________________________________________________________________________________________________________________
(Last Name) (First Name) (Middle Name)

Date and Place of Birth: _______________________________________ Nationality: ______________________ Gender: ______________________________

Parent / Guardian: ( ) Ms. ( ) Mrs. ( ) Mr. _____________________________________________________________________________________________
Home / Mailing Address (Complete): __________________________________________________________________________________________________
__________________________________________________________________________________________________
Admission Credentials: _________________________________________________________ Admission Status: ____________________________________
School Last Attended (Before admission to ADU): _______________________________________________________________________________________
Landline #: ____________________ Mobile #: ________________________________ E-mail Address: ___________________________________________

EDUCATIONAL BACKGROUND

PROGRAM SCHOOL DATE OF GRADUATION

Elementary: ___________________________ ________________________________________________________ _________________________

Secondary: ____________________________ ________________________________________________________ _________________________
Bachelor’s Degree: _____________________ ________________________________________________________ _________________________
Master’s Degree: _______________________ ________________________________________________________ _________________________
Thesis / Dissertation Title: __________________________________________________________________________________________________________
_________________________________________________________________________________________________________

PRESENTLY ENROLLED COURSES:

COURSES UNITS COURSES UNITS

_______________________________________________ _______________ _____________________________________________ _______________

_______________________________________________ _______________ _____________________________________________ _______________
_______________________________________________ _______________ _____________________________________________ _______________
_______________________________________________ _______________ _____________________________________________ _______________
_______________________________________________ _______________ _____________________________________________ _______________
_______________________________________________ _______________ _____________________________________________ _______________
_______________________________________________ _______________ _____________________________________________ _______________

AFFILIATIONS / ORGANIZATIONS POSITION DATE

_______________________________________________________ __________________________________________ ___________________________
_______________________________________________________ __________________________________________ ___________________________
_______________________________________________________ __________________________________________ ___________________________
_______________________________________________________ __________________________________________ ___________________________

I UNDERSTAND THAT:

1. I will have my picture taking at the Institutional Development and External Affairs (IDEA) Office.

2. If I have not completed all the academic and non-academic requirements two weeks before the Commencement date, I will not
be eligible for graduation and may not take part in the Commencement Exercise.

3. The Office of the Registrar may not act on this application if any of the above information is found to be incorrect.

Click the yellow box to insert your signature

_______________________________
Signature and Date

F-REG-304 Rev. 4 (08-01-20)

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