ADAMSON UNIVERSITY 2x2 Picture 900 San Marcelino Street, Ermita White Background Manila 1000, Philippines (Business Attire) Office of the Registrar Student Number APPLICATION FOR CANDIDACY FOR GRADUATION *This is to inform you that upon signing on this document you hereby provide your consent to ADAMSON UNIVERSITY (“AdU”), to process your personal data for the purpose of documentation and accreditation evidence. The Personal Data, including pic- tures, collected herein will only be used for the purpose stated above and will be stored and eventually be disposed securely in accordance to AdU’s retention and disposal policies. Completely fill up this form legibly: _____________________ _________________________________________ ________________________ Expected to Graduate Degree / Title Applied for Major (Term / Semester) Complete Name (Please print): _____________________________________________________________________________________________________________________ (Last Name) (First Name) (Middle Name) Date and Place of Birth: _______________________________________ Nationality: ______________________ Gender: ______________________________ Parent / Guardian: ( ) Ms. ( ) Mrs. ( ) Mr. _____________________________________________________________________________________________ Home / Mailing Address (Complete): __________________________________________________________________________________________________ __________________________________________________________________________________________________ Admission Credentials: _________________________________________________________ Admission Status: ____________________________________ School Last Attended (Before admission to ADU): _______________________________________________________________________________________ Landline #: ____________________ Mobile #: ________________________________ E-mail Address: ___________________________________________ EDUCATIONAL BACKGROUND PROGRAM SCHOOL DATE OF GRADUATION Elementary: ___________________________ ________________________________________________________ _________________________ Secondary: ____________________________ ________________________________________________________ _________________________ Bachelor’s Degree: _____________________ ________________________________________________________ _________________________ Master’s Degree: _______________________ ________________________________________________________ _________________________ Thesis / Dissertation Title: __________________________________________________________________________________________________________ _________________________________________________________________________________________________________ PRESENTLY ENROLLED COURSES: COURSES UNITS COURSES UNITS _______________________________________________ _______________ _____________________________________________ _______________ _______________________________________________ _______________ _____________________________________________ _______________ _______________________________________________ _______________ _____________________________________________ _______________ _______________________________________________ _______________ _____________________________________________ _______________ _______________________________________________ _______________ _____________________________________________ _______________ _______________________________________________ _______________ _____________________________________________ _______________ _______________________________________________ _______________ _____________________________________________ _______________ AFFILIATIONS / ORGANIZATIONS POSITION DATE _______________________________________________________ __________________________________________ ___________________________ _______________________________________________________ __________________________________________ ___________________________ _______________________________________________________ __________________________________________ ___________________________ _______________________________________________________ __________________________________________ ___________________________ I UNDERSTAND THAT: 1. I will have my picture taking at the Institutional Development and External Affairs (IDEA) Office. 2. If I have not completed all the academic and non-academic requirements two weeks before the Commencement date, I will not be eligible for graduation and may not take part in the Commencement Exercise. 3. The Office of the Registrar may not act on this application if any of the above information is found to be incorrect. _______________________________ Signature and Date F-REG-304 Rev. 4 (08-01-20) .