CAV / AUTHENTICATION FORM

 

Requirements:

 

1. LETTER OF CONFIRMATION from the School Registrar

2. TRANSCRIPT OF RECORDS – (Two (2) Xerox copies duly certified by the School Registrar and bears the Official School Seal)

3. DIPLOMA – (Two (2) Xerox Copies duly certified by the School Registrar

4. RLE / Certification of Clinical Experience (for BS Nursing graduates only – Two (2) Xerox copies duly certified by the College Dean and bears the Official School Seal)

5. Two (2) pieces 2 x 2 colored picture in white background, with nametag (the nametag should bear the name appearing in the credentials/documents)

6. Authorization letter and Xerox copy of representative’s valid Identification Card – in the absence of the applicant.

7. Application Fee Php. 40.00

 

 

FILL OUT THIS FORM COMPLETELY

 

1. Name of Applicant (appearing in the TOR & Diploma _______________________

2. Permanent Address ________________________________________________

3. School graduated & Address _________________________________________

4. Course (including MAJOR) ___________________________________________

5. Specific Date of Graduation __________________________________________

6. Special Order (B) No.: _____________, series of _______ Date ______________

7. Official Receipt No.: ___________________ Date issued ___________________

 

 

________________________

      Applicant’s Signature