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RO6Form 1


_______________________________ (Date) BUEN S. MONDEJAR Regional Director TESDA VI Zamora St., Iloilo City Thru: LORENA T. YUNQUE Provincial Director TESDA-Iloilo Sir: The undersigned ____________________________________ of the _____________________ c (head of institution) (position/designation) (name of TVI) c a ______________________________ located at ___________________________________________ c (type of school/institution) (complete address) c hereby petition for registration of the following courses/program and offer under the laws of the Republic of the Philippines. Courses/Programs ______________________________________ ______________________________________ ______________________________________ Duration _____________________ _____________________ _____________________

To support this petition are the following documents duly certified/authenticated: A. CORPORATE AND ADMINISTRATIVE DOCUMENTS 1. Certified Board Resolution to offer program 2. SEC Registration (for private institutions only) 3. Articles of Incorporation (for private institutions only) 4. Current Certificate of Ownership or Contract of Leases of at least five (5) years 5. Current Fire Safety Certificate B. CURRICULUM AND PROGRAM DELIVERY 1. Curriculum document complies with the competency standards where they exist 2. Course and subjects description 3. Curriculum document specifies the equipment (Form U2A/0402), tools (Form U2B/0402) and consumables (Form U2C/0402) necessary to deliver the program 4. Curriculum document specifies the instructional materials (Form U3/0302, books at least 10 titles with 2 copies/title; videotapes, internet access, etc.) 5. List of TIs physical facilities (Form U6A/0501, to include off-campus physical facilities Form U6B/0501) C. FACULTY AND PERSONNEL 1. Updated list of officials with their qualifications (Form U4A/0202) 2. Updated list of faculty teaching on the program and their qualifications (Form U4/0202, certificates attached) 3. Updated list of non-teaching personnel and their qualifications (Form U5/1100)

D. ACADEMIC RULES 1. Schedule and breakdown of tuition and other program cost 2. Documented Grading System 3. Entrance requirements 4. Rules on Attendance E. SUPPORT SERVICES 1. Health services (MOA with private physician/dentist if no regular Medical personnel are hired) 2. Career Guidance/Placement Services 3. Community Outreach Program 4. Research programs that supports the operations of the schools I, ____________________________________ as __________________________ promise to c (head of institution) (position/designation) maintain the standards required for the courses/programs and to follow faithfully all laws, the rules and regulations, and the requirements of the Technical Education and Skills Development Authority governing the operations of authorized technical-vocational institutions and to inform the Technical Education and Skills Development Authority of any action regarding closure or phasing out of the courses/programs or any changes in the prescribed requirements. I acknowledge that the violation of the laws, the rules and the regulations, and the requirements of the Technical Education and Skills Development Authority shall be deemed sufficient cause for revocation of the authority granted. The institution will not conduct classes in the courses/programs applied for above until and unless this application is approved and the Technical Education and Skills Development Authority issue the corresponding Certificate. Very truly yours,

_______________________________ (Signature over printed name)


To be filled up by the Applicant Institution TI Contact Person: _________________________________ Telephone No/s.: __________________________________ Position: _____________________ Fax No.: ______________________

e-mail address: ______________________________________________________________________ To be filled-up by TESDA-PO UTPRAS Focal Date/s of Submission of Requirements: ___________________________________________________ Date of Completion of Requirements: ____________________________________________________ Date of Inspection: ___________________________________________________________________