Fillable OFFICE OF THE REGISTRAR PERMIT FOR EXAMINATION

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OFFICE OF THE REGISTRAR PERMIT FOR EXAMINATION

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Republic of the Philippines
MINDANAO STATE UNIVERSITY
9500 Fatima Campus, Fatima, General Santos City
www.msugensan.edu.ph /registraroffice@msugensan.edu.ph
OFFICE OF THE REGISTRAR
PERMIT FOR EXAMINATION
1)
NAME_______________________ of the College of []CBA,[]CED,[]CNSM,[]COA,[]COE,[]COF&[]CSSH
(LName, FName, M.I.)
is given permit for the following purpose/s:
Please fill up 3 copies, check box and follow the number sequence (1-9) in accomplishing
the form.
[ ] – Final Examination not taken
[ ] – Waiver [ ] – Complete other requirements
SUBJECT CODE:_________,SECTION:_________COURSE CODE:_________,
TERM:[]1
st
,[]2
nd
&[]SUM,Sch.Year:_________ - _________
2) _________________________ _______/________/20________
RECORD EXAMINER / ASSESSOR (Registrar’s Office) Date
3) –NO PAYMENT/ –P20.00 RECEIPT NO.:________ DATE OF RECEIPT:________
Recommended by:
4) ________________________ 5) ________/_______/20_______
NAME & SIGNATURE OF INSTRUCTOR DATE OF EXAMINATION / COMPLETION
6) (TAKE EXAMINATION OR SUBMIT REQUIREMENTS)
7) REPORT OF GRADE
NAME:________________________________ COLLEGE:[]CBA,[]CED,[]CNSM,[]COA,[]COE,[]COF&[]CSSH
(LName, FName, M.I.)
SUBJECT CODE:___________ DESCRIPTION: ___________________________________________
8) REMOVAL/COMPLETION GRADE: CREDIT: UNIT/S
____________________________________
SIGNATURE OVER PRINTED NAME OF INSTRUCTOR
____________________________________
ACADEMIC RANK
9)
RECEIVED BY: ___________________________________ ON _______/_______/20_______
(Registrar’s Office) NAME DATE
=================================================================================
PERMEXAM_CASTILLO v1.1.DOC 03/31/2002-07/03/2007
IMPORTANT: No REMOVAL examination or COMPLETION and grade shall be given by the
FACULTY prior to APPROVAL of this form; INSTRUCTOR shall indicate examination date prior
to assessment and approval of the Registrar; grade must be submitted to the Registrar’s Office
not later than 3 days after the approved examination date.
I.D. NUMBER
TERSA R. CASTILLO, MS
CAMPUS REGISTRAR
✔
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OFFICE OF THE REGISTRAR PERMIT FOR EXAMINATION

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Completed 5 February 2022

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