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MCC Reg Form 10 - Application For School Record

This document is an application form for school records from the Office of the College Registrar, requiring personal and academic information from the student. It includes sections for requested documents such as transcripts, diplomas, and certifications, as well as clearance from various college offices. The form also includes a consent statement for the processing of personal information.

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15 views1 page

MCC Reg Form 10 - Application For School Record

This document is an application form for school records from the Office of the College Registrar, requiring personal and academic information from the student. It includes sections for requested documents such as transcripts, diplomas, and certifications, as well as clearance from various college offices. The form also includes a consent statement for the processing of personal information.

Uploaded by

dr0007.brt
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
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MCC Reg. Form No.

10
rev. 04
March 20, 2024

OFFICE OF THE COLLEGE REGISTRAR

APPLICATION FOR SCHOOL RECORD

STUDENT PERSONAL INFORMATION

Student ID No.: _________________


Title: ( ) Mr. ( ) Ms.
Name:
(Surname) (First Name) (Middle Name) (Maiden Name)
(For married female only)

Address: ___________________________________________________________________________________
Date of Birth: _______________________ Place of Birth: ____________________________
FB Account Name (for Reference): ______________________ Contact No.: ___________________________

ACADEMIC INFORMATION
Program: _______________________________________ Year Graduated: _________________________
No. of Semesters Attended (for Undergraduate only): ___________________________________________________
School Last Attended (before MCC):

“By signing this form, I give consent to the collection, use, disclosure, and processing of my personal
and/ or sensitive information.”

Signature over printed name /


Authorized Representative
REQUESTED DOCUMENT(S)

Transcript of Records Transfer Credentials


(Includes Cert. of Eligibility to Transfer, Good Moral, and
[ ] 1st copy [ ] 4th copy
Copy of Grades)
[ ] 2nd copy [ ] 5th copy Certifications
[ ] 3 copy
rd
Please specify:
Diploma (Duplicate Copy) ______________________________________
CAV _______________________________________

Purpose:
CLEARANCE

College Library Cashier Institutional Advancement


Coordinator (OVPGROW)
(Applicable for MCC graduates only)

Office of the Discipline Guidance Counselor


Officer (For Exit Interview)

Date of Released: O.R. No.:


Number of Sheets: Date Issued:
Amount Paid:

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