Registration No: 1071715

Republic of the Philippines

DON HONORIO VENTURA STATE UNIVERSITY
DHVSU - Bacolor Campus
2nd Semester AY 2023-2024

CERTIFICATE OF REGISTRATION

STUDENT GENERAL INFORMATION

Student No: 2020102646 Course: Bachelor of Science in Industrial Technology
Name: SAHAGUN, Kerwin R. Year Level: 4th Year

U N I T
CODE SUBJECT TITLE Lec Lab Credit
SECTION SCHEDULE / ROOM
OJT 4210 Industrial Immersion 3 10 0 10 BSIT 4A - AT
Total Subject/s: 1 Total Unit(s) 10 0 10

A S S E S S S E D F E E S
Tuition Fees (TF@10) 2,200.00
School ID Fees 5.00
DOLORES D. MALLARI, PH. D.
Registration Fees 100.00
Miscellaneous Fees 70.00 UNIVERSITY REGISTRAR
Medical/Dental Fees 80.00
Library Fees 150.00
SCHEDULE FOR THE REFUND OF FEES (Tuition fees only) IF APPLICABLE
Laboratory Fees 150.00
Guidance Fees-CB SEP 500.00 Regular Classess Summer
Guidance Fees 50.00 Within 1 week from the Within the 2nd day after
- 10% charges - 10% charges
Development Fees-IRSF 1,700.00 opening of classes the opening of classes
Cultural Fees 100.00
Within the 3rd/4th day
Computer Fees 200.00 Within the 2nd week - 20% charges - 20% charges
after the opening of
Athletic Fees 160.00
Development Fees-USC Fees 70.00 5th day after the
Within the 3rd week - 30% charges - No refund
Development Fees-Industrialist Fees 70.00 opening of classes
Development Fees-CIT (Main) College Fees 50.00
Total Assessment : 5,655.00 Within the 4th week - No refund
Less: Financial Aid : 0.00
Net Assessed : 5,655.00
Total Payment : 0.00 In consideration of my admission to Don Honorio Ventura State University and
Credit Memo : 0.00 of the privileges of students in this Institution. I hereby abide by and comply with
Total Balance : 5,655.00 all the rules and regulations laid down by competent authorities Don Honorio
Ventura State University in which I am enrolled.
Addt'l Prev. Balance : 7,465.00
Outstanding Balance : 13,120.00

DATA PRIVACY CONSENT

By signing this information sheet/application form, you are hereby giving STUDENT SIGNATURE
your consent to DHVSU to collect/process your personal data.

SIGNATURE OVER PRINTED NAME Official Receipt:

Date of Payment:

Date Printed : February 06, 2024

DHVSU-QSP-REG-001-FO003-R00