Fillable REG 109 (09/2009) VAAEPS-

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REG 109 (09/2009) VAAEPS-

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VAAEPS-
REG 109 (09/2009)
UNIVERSIDAD INTERAMERICANA DE PUERTO RICO
Oficina de Registraduría
INT E R AME R I CA N UNIV E RS I T Y O F P UE RT O R I CO
Of fi ce of th e Reg i stra r
SOLICITUD DE CERTIFICACIÓN
CERTIFICATION REQUEST
POR FAVOR, LEA LAS INSTRUCCIONES ANTES DE COMPLETAR ESTE FORMULARIO. / PLEASE READ THE INSTRUCTIONS BEFORE COMPLETING THIS FORM.
Número de Identificación:
Identification Number
Nombre y Apellidos: / First Name , Father's Surname, Mother's Maiden Surname
Recinto o Unidad Académica:
Campus
Nivel de estudios a certificar: Level of studies to be certified:
Technical Certificates
Nivel Subgraduado (Asociado y Bachillerato)
Undergraduate Level (Associate and Bachelors)
Nivel Profesional
Professional Level
Nivel Graduado (Maestría)
Graduate Level (Masters)
Nivel Graduado (Doctorado)
Graduate Level (Doctoral)
Certificación de:
Certification of:
Matrícula o Estudios
Registration or Studies
Notas
Grades
Graduación
Graduation
Otros ( Indique)
Other ( Indicate)
Término Académico de Certificación / Academic Term of Certification
Propósito de la Certificación / Purpose of the Certification
agosto (Intensivo)
August (Intensive)
enero (Intensivo)
January (Intensive)
Plan Médico
Medical Plan
agosto a diciembre
August to December
enero a mayo
January to May
Departamento. de Hacienda
Department. of the Treasury
agosto a octubre
August to October
enero a marzo
January to March
Trabajo
Work
octubre a diciembre
October to December
marzo a mayo
March to May
Programa de desempleo
Unemployment Program
noviembre a febrero
November to February
febrero a mayo
February to May
Préstamo estudiantil
Student Loan
verano (junio)
Summer (June)
verano (julio)
Summer (July)
Otros
Other
Comentarios: / Comments:
Solicitud de Certificación de Graduación : Español Inglés
Enviar a la siguiente dirección:
Send to the following address
Fecha: / Date
Firma del Estudiante: / Student's Signature
Teléfono: / Telephone
Correo Electrónico: / Email
INSTRUCCIONES / IN STRU CTI ONS
1. Este Formulario se utiliza para solicitar la certificación de información académica que contiene el expediente académico del estudiante en la Oficina de
Registraduría. / This form is used to request the certification of academic information included in the student's academic record in the Office of the
Registrar.
2. La certificación no incluye información sobre aspectos financieros o de asistencia económica. / The certification does not include financial or financial
aid information.
3. De ser necesario, use el espacio de comentarios para ofrecer detalles sobre el contenido de la certificación que está solicitando. / If necessary, use the
comments box to give details on the content of the certification you are requesting.
4. Debe pasar por la Oficina de Recaudaciones para efectuar el pago correspondiente: cada certificación tiene un costo de $2.00. You must visit the Bursar´s Office and
make the payment. Each certification costs $2.00
5. Entregue la solicitud en la Oficina de Registraduría. / Submit this request to the Office of the Registrar
PARA USO DE LA OFICINA DE RECAUDACIONES
__$__________________ ___________________ ____________________________ ______________________________________________
Cantidad Pagada Fecha Sello de Pago Firma Técnico de Recaudaciones
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