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Semestral Clearance

The document is a semestral clearance form for students in the College of Nursing & Allied Sciences, detailing required lab results, PET portfolio status, RLE account status, and academic matters. It includes sections for signatories from various authorities such as the registration committee, class adviser, college secretary, clinical coordinator, and program head. The form indicates whether students are clear for enrollment and includes remarks for any additional notes.

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9 views1 page

Semestral Clearance

The document is a semestral clearance form for students in the College of Nursing & Allied Sciences, detailing required lab results, PET portfolio status, RLE account status, and academic matters. It includes sections for signatories from various authorities such as the registration committee, class adviser, college secretary, clinical coordinator, and program head. The form indicates whether students are clear for enrollment and includes remarks for any additional notes.

Uploaded by

jvtb12345
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

COLLEGE OF NURSING & ALLIED SCIENCES COLLEGE OF NURSING & ALLIED SCIENCES COLLEGE OF NURSING & ALLIED SCIENCES

\ SEMESTRAL CLEARANCE SEMESTRAL CLEARANCE SEMESTRAL CLEARANCE


__ Semester, SY ___- ___ __ Semester, SY ___- ___ __ Semester, SY ___- ___
_____________ _____________ _____________
Date: Date: Date:
Name: __________________ Student# __________ Name: __________________ Student# __________ Name: __________________ Student# __________
Program _______________ Year ______ Sec ____ Program _______________ Year ______ Sec ____ Program _______________ Year ______ Sec ____

Lab/Dx results: Signatories Lab/Dx results: Signatories Lab/Dx results: Signatories


UA / UA with UCG Registration Committee UA / UA with UCG Registration Committee UA / UA with UCG Registration Committee
Chest X-ray Chest X-ray Chest X-ray
Hepa B Determination ______________ Hepa B Determination ______________ Hepa B Hepa B Determination ______________

PET Portfolio Class Adviser PET Portfolio Class Adviser PET Portfolio Class Adviser
Complete Complete Complete
Incomplete ______________ ______________ ______________
Incomplete Incomplete
RLE Account: College Secretary RLE Account: College Secretary RLE Account: College Secretary
Fully paid Fully paid Fully paid
Balance: ____ ______________ Balance: ____ ______________ Balance: ____ ______________
RLE Matters: Clinical Coordinator RLE Matters: Clinical Coordinator RLE Matters: Clinical Coordinator
Complete RLE Hours Complete RLE Hours Complete RLE Hours
No SL/Clinical liabilities ______________ No SL/Clinical liabilities ______________ No SL/Clinical liabilities ______________
Academic Matters: Program Head Academic Matters: Program Head Academic Matters: Program Head
Passed all subjects
No impediments ______________ ______________ ______________

Remarks: Remarks: Remarks:


[ ] Clear for enrollment [ ] Clear for enrollment [ ] Clear for enrollment
[ ] others: [ ] others: [ ] others:
_______________________________ _______________________________ _______________________________
College Dean College Dean College Dean
ESSU-CONAS-199 I Version 1 ESSU-CONAS-199 I Version 1
ESSU-CONAS-199 I Version 1
Effectivity Date: March 15, 2024 Effectivity Date: March 15, 2024
Effectivity Date: March 15, 2024

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