On-Line Application Form

 
  Transcript of Record   Purpose:
  Form 137        Employment
  Certification:        Personal Copy

           Graduate

           Undergraduate

           Medium of Instruction

       Other
  Name:
*
*
Last
First
MI
Student #: *
Course/Major:
 
Latest Enrolment:
Date of Graduation:
 
  Address: (Please indicate complete address if deliver - 3 lines provided below)
   
   
   
  Zip Code:  E-mail Address:
  Tel # :  Mobile #:
  Mode of Transaction:
Pick-up
Cost: (Rate is within the Philippines only. We will get in touch with you for any other preferred destination outside the Philippines.)

By checking on the "I Accept" box below, I declare that I have read and fully understood the content and information in the JRU "On-line Application Form" and hereby declares JRU free and harmless from any liability if applied/received by any person other than me or any of the following person(s) detailed below. In case of minority or I am not avialable to receive my requested document(s), I am authorizing any of the following persons to receive the same in my behalf with my I.D and the ID of any assigned person being presented. My : a. Parents; b. Spouse; c. Direct descendants; d. Siblings; or e. Legal guardian/institution-in-charge.

(We reserve the right to ascertain relationship of applicant to any of the above person prior to the release of document(s).)

I Accept                      I Decline

 

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