Republic of the Philippines

WESTERN MINDANAO STATE UNIVERSITY

OFFICE OF THE UNIVERSITY REGISTRAR 1904
Zamboanga City

Zamboanga City
Normal Road, Baliwasan, Zamboanga City 7000 http://www.wmsu.edu.ph
Philippines email registrar@wmsu.edu.ph
Tel No. (062) 991-1771 Fax No. 993-0695

APPLICATION FOR COMPLETION OF GRADES (UNDERGRADUATE)

Steps in filling-in of completion form:

1. Accomplish this form in triplicate
a. Deans Copy
b. Registrars Copy
c. Students Copy
2. Please follow the order of signature as indicated below.
3. Conditional and incomplete ratings that are not removed within one (1) year after the ratings have been recorded are
automatically converted to failure (5.0).

I would like to apply for completion examination/requirements for:

Subject : Description :

1.
Signature over printed of Name of Student Course

Please Check: ( )1st Semester ( ) 2nd Semester ( ) Summer

O.R. No.: Date: Amount Paid:

2. Verified by:

3. PILAR S. ENCARNADO, MPA

University Registrar

To
Instructor/Professor

COLLEGE OF
Please give the appropriate requirements and/or examination to the student concerned and submit his/her grade as soon as
possible.
4.
Signature over Printed name of Dean
FOR THE DEAN/UNIVERSITY REGISTRAR
I hereby certify that has taken the completion with me
name of student
and obtained the grade of
In figure in words

5.
Signature over Printed name of Faculty

Received by:
Deans Copy: Registrars Copy: Students Copy: