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Delen Christine Joy Pontines 18-53346 11-01-1999 22 Brgy. Conde Itaas, Batangas City Filipino 09165982354

The document is an application form for a student named Christine Joy P. Delen requesting to shift or transfer programs. She is currently enrolled in the BS Accountancy program at BatStateU and wants to shift to the BS Management Accounting program. She took courses in her previous program but did not meet the required grades. If approved for the shift, her previous courses would be evaluated for equivalents in the new program. The form provides spaces to list her courses, have them evaluated by the admitting program, and get approval from the academic affairs office to shift programs.

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Christine Joy Delen
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73 views3 pages

Delen Christine Joy Pontines 18-53346 11-01-1999 22 Brgy. Conde Itaas, Batangas City Filipino 09165982354

The document is an application form for a student named Christine Joy P. Delen requesting to shift or transfer programs. She is currently enrolled in the BS Accountancy program at BatStateU and wants to shift to the BS Management Accounting program. She took courses in her previous program but did not meet the required grades. If approved for the shift, her previous courses would be evaluated for equivalents in the new program. The form provides spaces to list her courses, have them evaluated by the admitting program, and get approval from the academic affairs office to shift programs.

Uploaded by

Christine Joy Delen
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Reference No.: BatStateU-FO-REG-12 Effectivity Date: July 1, 2021 Revision No.

: 02

APPLICATION FORM FOR SHIFTER/TRANSFEREE


Request to:  Shift: 
___ From another College of the same Constituent Campus ___ From the same College
Transfer: ___ From another Constituent Campus ___ From other university
PERSONAL INFORMATION
Name of DELEN PONTINES
Student:
CHRISTINE JOY
Last Name First Name Middle Name Suffix
SR Code: 18-53346 Date of Birth: 11-01-1999 Age: 22
Permanent
Address:
BRGY. CONDE ITAAS, BATANGAS CITY
Nationality: FILIPINO Contact Number: 09165982354
Program Preferred Constituent
Applied for: BS MANAGEMENT ACCOUNTING Campus:
Previous Previous Constituent
Program: BS ACCOUNTANCY Campus/University:
Reason for Shifting/ FAILURE TO MEET THE REQUIRED GRADES FOR THE PROGRAM
Transferring:

Requested by:

CHRISTINE JOY P. DELEN


__________________________ ETHEL P. DELEN
__________________________
Signature over Printed Name of Student Signature over Printed Name of Parent/Guardian
Date Signed: 01-02-2022 Date Signed: 01-02-2022
---------- to be filled-out by the Evaluator of the Admitting College ----------
Course/s taken from Previous Program/University Final Credit Equivalent Course/s in the
Course Code Course Title Grade/s Unit/s Preferred Program

(Use extra sheets if necessary)


Evaluated and Interviewed by: Reviewed and Approved by:
Qualified to Shift/ Transfer:
Yes, Program: _______________________________
No, Reason/s: _______________________________

MA.____________________________
CONCEPCION MANALO ____________________________
Signature over Printed Name of Dean/Head, Academic Affairs
Department/Program Chairperson Date Signed:
Date Signed:

Page 1 of 3
---------- to be filled-out by Testing and Admission Office ----------
This part is applicable ONLY for applicants from other universities
Examination Rating Verified by: Remarks:

The student is eligible to shift program/


_______________________________ transfer:
Signature over Printed Name of
Authorized Official YES NO
Designation:
Date Signed:
To the Campus Registrar:

The applicant is allowed to shift/transfer to: under

the College of

effective Semester, Academic Year .

Sincerely yours,

_____________________________
Signature over Printed Name of
Dean/ Head, Academic Affairs
Date Signed:
Received by:

______________________________
Signature over Printed Name of Registrar’s Staff
Date Signed:

Page 2 of 3
Annex A
Republic of the Philippines
BATANGAS STATE UNIVERSITY
(Name of Campus)
(Campus Address)

PROPOSED COURSES FOR ENROLLMENT

Name: Program:
Campus: Academic Year:

YEAR 1
First Semester
Unit/s Pre-
Course
Course Title requisite/ Remarks
Code Lec Lab Co-requisite

Total Units
Second Semester
Unit/s Pre-
Course
Course Title requisite/ Remarks
Code Lec Lab Co-requisite

Total Units
Midterm
Unit/s Pre-
Course
Course Title requisite/ Remarks
Code Lec Lab Co-requisite

Total Units
(Use additional sheets if necessary)
Evaluated by: Approved by:

___________________________________ ___________________________________
Signature over Printed Name of Signature over Printed Name of
Department/Program Chairperson Dean/ Head, Academic Affairs
Date Signed: Date Signed:
Required Attachment: Program Curriculum

Page 3 of 3

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