GSR Form No.

01 (Revised 2016)

Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
COURSE PREREGISTRATION
Office of the Vice President for Academic Affairs _____ Semester, SY 20____-____
GRADUATE SCHOOL Summer, 20 _____

NAME: Mr./Ms. Date of Registration:

(PLS. PRINT) (Surname) (First Name) (Middle Name)

Student No. Program: Contact Nos.:

New Student Old Student Returning Cross-enrollee
Subject Code Subject Description Section Code Day/s Time Room

Adviser’s Approval ________________________ __________________________

Date ________________________ Student’s Signature & Date

NOTE: A student is considered officially enrolled when he/she has paid the tuition and other fees
(in full or installment) and when he/she has claimed his/her printed registration certificate.

GSR Form No. 01 (Revised 2016)

Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES
COURSE PREREGISTRATION
Office of the Vice President for Academic Affairs _____ Semester, SY 20____-____
GRADUATE SCHOOL Summer, 20 _____

NAME: Mr./Ms. Date of Registration:

(PLS. PRINT) (Surname) (First Name) (Middle Name)

Student No. Program: Contact Nos.:

New Student Old Student Returning Cross-enrollee
Subject Code Subject Description Section Code Day/s Time Room

Adviser’s Approval ________________________ __________________________

Date ________________________ Student’s Signature & Date

NOTE: A student is considered officially enrolled when he/she has paid the tuition and other fees
(in full or installment) and when he/she has claimed his/her printed registration certificate.