CHED Form A1-2002 Revised May 2006

INSTITUTIONAL PROFILE
(Type Academic Year Here)
PLEASE READ THE INSTRUCTIONS BEFORE FILLING OUT THE FORMS
DATA ITEMS DATA ENTRIES
Institution Name (no abbreviation please) : Type Institutional Name here
Unique Institutional Identifier : Type SCHOOL CODE here
Institutional Form of Ownership (pls. see below) : Type SCHOOL TYPE here , please see below
Street : Type STREET here
Address Municipality : Type MUNICIPALITY/TOWN here
Province/City : Type PROVINCE/CITY here
Region : Type REGION here
Postal or Zip Code : Type ZIP CODE here
Institutional Telephone (include Area Code) : Type TELEPHONE NO. here
Institutional Fax No. (include Area Code) : Type FAX NO. here
Institutional Head's Telephone ( include Area Code) : Type Head's TELEPHONE NO. here
Institutional E-mail Address : Type E-MAIL here
Institutional Web Site : Type WEB PAGE here
Year Established : Type YEAR ESTABLISHED here
Latest SEC Registration/Enabling Law or Charter : Type REGISTRATION here
Date Granted or Approved : Type YEAR GRANTED here
Year Converted to College Status : Type YEAR CONVERTED to COLLEGE here
Year Converted to University Status : Type YEAR CONVERTED to University here
Name of Institutional Head : Type Name of the Institutional Head here
Title of Head of Institution : Type TITLE here
Highest Educational Attainment of the Head : Type HIGHEST EDUC'L. ATTAINMENT here

X-Coordinate : Type LOCATION COORDINATE (X) here

Y-Coordinate Type LOCATION COORDINATE (Y) here

Remarks : Type REMARKS here

List the former Name(s) of your Institution and the corresponding years your Institution used such name.
(Please write N/A if not applicable and insert row if needed.)
Name Year
Start here Type YEAR here

DEAN PROFILE DEAN PROFILE DEAN PROFILE DEAN PROFILE DEAN PROFILE DEAN PROFILE
(Please write N/A if not applicable and insert row if needed.) DEGREE EARNED (Pls. type the full Degree Description)
College/Discipline Assignment (e.g.
Name of Dean (Last Name, First Name Middle Initial) Designation (e.g. Program Dean, College Head) Baccalaureate Masters Doctoral
College of Liberal Arts)
Start here Start here Start here Start here Start here Start here

Accomplished by: Certified Correct:

Type NAME here Type NAME here

Type POSITION here Type POSITION here

Type DATE here Type DATE here

Date Accomplished Date Certified

Entry for Institutional Form of Ownership:

Chartered State College/University (Main)
Chartered State College/University (Satellite Campus)
CHED-Supervised Institution
Local Government College/University
Private Sectarian Stock
Private Sectarian Non-Stock
Private Non-Sectarian Stock
Private Non-Sectarian Non-Stock
Private Sectarian Foundation
Private Non-Sectarian Foundation
Others, please specify
CHED E-FORM B/C 2004
DO NOT FILL THIS PORTION Region: Type REGION here Type: Type SCHOOL
Unique Institutional Identifier: Type SCHOOL CODE here
Institution Name : Type Institutional Name here
Address: Type STREET here, Type MUNICIPALITY/TOWN here, Type PROVINCE/CITY here
CURRICULAR PROGRAM PROFILE/
ENROLMENT & GRAUATES NOTE: SUCs only means the entries are required to be filled out by State Universities and Colleges
PLEASE READ INSTRUCTIONS BEFORE FILLING OUT THIS FORM
Government Authority
With R E M A R K S about the program
PROGRAM/COURSE Thesis/Dissert Program such as: Newly Offered, Center of Program Normal
Issued
ation? Status (Use Excellece/Development, Accredited Mode Length
Year by Year Issued by
Code) (Level II until Dec. 2010), etc., if GP No. GR No. (Use Code) (In Years)
Granted (Use Granted (Use Code)
Main Program/Course Major 1 - Yes any. Code)
NO ABBREVIATION PLEASE & INSERT ROW IF NEEDED 2 - No

Doctoral (please enumerate, insert rows as needed):

Start here

Master's (please enumerate, insert rows as needed):

Start here

Post-Bacc. (pls. enumerate, insert rows as needed):

Start here

Baccalaureate (pls. enumerate, insert rows as needed after the first entry and copy the formula under the Sub-Total and Totals of Enrollment and Graduates ):
Start here

Pre-Bacc. (ladderized Associate, diploma program. Pls. enumerate, insert rows as needed):
Start here

Voc./Tech (pls. enumerate, insert rows as needed):

Start here

Page 2 of 7
Secondary (High School)
Elementary
Pre-School
TOTAL
Accomplished by: Certified Correct by:

Type NAME here Typ

Type POSITION here Typ

Type DATE here Ty

Date Accomplished

Page 3 of 7
SCHOOL TYPE here , please see below

ENROLMENT
Program Credit
(In Units)
Program Tuition per 1st Sem/1st Trimester/Term, AY 2009/10
(for SUCs only) Program Fee Enrolled Units (for
Credit (In Unit
(In Peso) SUCs only)
Units) (In Peso)
New Students (1st Year) 1st Year 2nd Year 3rd Year 4th Year 5th Year 6th Year 7th Year Sub-Tota
Lab Lecture
M F M F M F M F M F M F M F M F M

0
0
0
0
0
0

0
0
0
0

0
0
0
0
0
0

Page 4 of 7
 0
0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Type NAME here

Type POSITION here

Type DATE here

Date Certified

Page 5 of 7
 ENROLMENT GRADUATES
Total of 1st, 2nd AY
1st Sem/1st Trimester/Term, AY 2009/10 2008/09 & Summer
2009
Sub-Total
TOTAL M F TOTAL
F

0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

Page 6 of 7
0 0 0
0 0 0
0 0
0 0 0 0 0

Page 7 of 7