Tentative and Assessment Form

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Rizal, Philippines

TENTATIVE AND ASSESSMENT FORM

Campus : Rizal Academic Term : Second Academic Year : 2023-2024


Applicant No : CA202207235 Full Name : JOROSS BON PASCUAL Sex : Male
Course : BSTM-B Major : Year Level/Status : 2nd-REGULAR
Home Address : LOWER EASTMENT KABISIG, SAN ANDRES (POB.), CAINTA, RIZAL Contact Number : 09063001342

Subject/s Section Lab Units Lec Units Days Time and Date Room

Tuition Fee Laboratory Fee Miscellaneous Fee Special Subject Total Amount

130.00 0.00 2,270.00 0.00 2,400.00

Other Fees 100.00


LMS Fee 300.00
Student Portal Fee 300.00
Drug Test 200.00
Mailing Fee 60.00
Health Diagnostics 350.00
Test Booklet 30.00
TOTAL Php 3,740.00

Cash Payment Installment Payment Schedule


Php 3,740.00 Amount Due Dates Late Payments Penalties
Downpayment 1,380.00 Jan 11, 2024 5% Jan 12 onwards
10% Cash Discount 1st Installment 594.75 Feb 01, 2024 5% Feb 02 onwards
2nd Installment 594.75 Feb 16, 2024 5% Feb 17 onwards
for FULL PAYMENT 3rd Installment 594.75 Mar 01, 2024 5% Mar 02 onwards
4th Installment 594.75 Mar 16, 2024 5% Mar 17 onwards
made on or before 5th Installment 264.35 Apr 01, 2024 5% Apr 02 onwards
TOTAL 4,023.35
Jan 09, 2024

I shall abide by all the rules and regulations now enforced or may be promulgated by the School Management System from time to time, likewise,
I agree to the cancellation of the credits I have earned in subjects and have enrolled under false pretensed.

REMINDER: Date & Time Accomplished


Upon completion and printing of this PRE-ENROLLMENT, payment of either in CASH or DOWN PAYMENT
12:46PM / 09 Jan 2024
MUST BE SETTLED WITHIN 48 HOURS otherwise class schedules will be automatically deleted.

Prepared by: JOROSS PASCUAL

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