Revised as of 8/25/0303 UNIVERSITY OF THE PHILIPPINES MANILA The Health Sciences Center

APPLICATION FOR PRIVILEGE TO STUDY AT REDUCED FEES

NAME DESIGNATION DEPARTMENT COLLEGE/UNIT Semester/Summer/Trimester Academic Year

COURSES DAYS TIME UNIT

APPROVED TOTAL NO. OF UNITS TO BE ENROLLED IN

Date Signature

(For Faculty)  RECOMMENDED  NOT RECOMMENDED APPROVED ACADEMIC LOAD OF APPLICANT

Actual teaching load units Chairman Units credits for non-teaching Date Activity (Research/Extension)  RECOMMENDED Study Load  NOT RECOMMENDED

TOTAL UNITS Dean/Director/Head of Office

Appointment Status Approved for enrollment not more than units at reduced fees.  Tenured/Permanent  Non-tenured/Temporary No student shall be allowed to enroll beyond total number of units (Inclusive dates of current appointment) approved herein.

 On study leave (inclusive dates)

Director, HRDO Date VCAA Date

Attachments: 1. Copy of approved request to study as per BOR approved minutes of September 25, 2003. 2. Program of study 3. Copy of grades issued by the Registrar’s Office for the last semester enrolled in (if for renewal)

Reminders: The total number of approved units for enrollment shall in no case constitute basis for claiming overload honorarium. As a general rule, faculty members with Study Load Credits (SLC) should not be assigned any overload teaching.