De La Salle University Dasmariñas SHSREGFORM024

Senior High School v.1.082817

APPLICATION FOR CHANGE OF GRADES

No change of grade will be entertained at the Office of the Asst. Registrar beyond two (2) weeks after the
deadline for submission of grades as announced for the semester or beyond one(1) week after the deadline
for submission of grades as announced for the summer. This form should be submitted personally by the
faculty to the Office of the Asst. Registrar.

Date Filed
TO: THE ASST. REGISTRAR
The Midterm/Final Grades of
Student's Full Name
for the First Second Summer
Student's Program Code Semester / Summer
should be changed as follows:
School Year

GRADE TO CHANGED
COURSE CODE NAME OF FACULTY
FROM TO

REASON/S FOR CHANGING GRADE:

(Please attach the minutes of meeting of the committee duly signed by the members)
Endorsed for Approval:

(Faculty Member's Signature Over PRINTED NAME) (Track Coordinator's Signature Over PRINTED NAME)
Date Signed: Date Signed:

APPROVED:

Asst. Registrar's Signature Over PRINTED NAME Director's Signature Over PRINTED NAME
Date Signed: Date Signed:

cc: SHS Asst. Registrar, Director, Track Coordinator, File