Medical Colleges of Northern Philippines

Alimannao Hills, Peñablanca, Cagayan

OFFICE OF THE STUDENT SERVICES

AFFIDAVIT OF ACKNOWLEDGEMENT OF SCHOOL POLICIES

I, ___________________________, ______ years of age, and a resident of

__________________________________ after having been sworn to in accordance with the law, do hereby
depose and say that:
1. I have freely and voluntarily applied for admission to MCNP, and as such I submit to its rules and
regulations, as well as to all rules and regulations that the school’s administration may subsequently
enact;
2. I agree to submit to the penalty of expulsion from the school in case of a serious infraction of any of the
rules mentioned in paragraph 1 hereof, when my guilt is established by competent authority in
accordance with administrative due process;
3. I do not belong to any organization, movement, or a group that is not recognized nor approved by the
MCNP administration, and I acknowledge membership in any such organization, movement or group is
contrary to the basic policies of the school, and may constitute ground for dismissal;
4. In the interest of the unhampered delivery of educational services, I accept the established channels of
communication, and dialogue with administration, when this should be necessary, and likewise accept
that engaging in mass action whatsoever that is disruptive of the good order of the school, or injurious
to its reputation, or that result in fragmenting the school community in any measures whatsoever is a
serious offense and punishable by dismissal;
5. I acknowledge that my admission to MCNP is on an annual basis only and that the school reserves the
right to deny my admission in succeeding years on the basis of its school policies as well as the sound
discretion of the administration.
6. I have read the relevant disciplinary manuals and school rules and regulations and submit myself to the
provisions therein for compliance.

___________________________
Signature Over Printed Name

___________________________
Year/ Course

Witnesses:

___________________________
Class Adviser

__________________________
Date

Conforme:

_________________________________
Signature of Parent/s Over Printed Name