JOSE MARIA COLLEGE FOUNDATION, INC.
STUDENT CLEARANCE FORM
___ SEMESTER OF S.Y. _________
NAME : _
PROGRAM: ______ YEAR LEVEL:__________
OFFICE CLEARANCE/SIGNATURE DATE
1. Library
2. Guidance
3. Prefect of
Discipline
4. Student President Treasurer
Organization
(Departmental)
5. Supreme Student President Treasurer
Council
6. Registrar
7. Scholarship Office
8. OSAS
9. Program Head
10. Dean
11. Finance
12. Research
13. Alumni
(Graduating)
14. Student
Publication
I HEREBY CERTIFY that the information provided in this form is complete, true and correct to the
best of my knowledge. FURTHER, I HEREBY ACKNOWLEDGE that I have understood the code of
honesty and the provisions on the JMCFI School Policies and agree thereto as well.
SIGNATURE ABOVE PRINTED NAME OF STUDENT