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Document No.

WVSU-REG-SOI-02-F06
STUDENT’S RE – ENTRY FORM Issue No. 1
Revision No. 0
Date of Effectivity: May 15, 2018
WEST VISAYAS STATE UNIVERSITY Issued by: Registrar’s Office
Page No. Page 1 of 1

STUDENT’S RE – ENTRY FORM

Name: ALEJO BENJIE CORDA ID No.: 13-0260-GS


(Family) (First) (Middle)

College of EDUCATION Campus: MAIN-LA PAZ

Course / Year / Section: Doctor of Philosophy in Educ. Major / Specialization: Educational Management
(before leave of absence)

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Date ____________________

The Dean
College of Education
This University

Dear _________________________:

I am respectfully applying for re – entry at the West Visayas State University after a leave of absence
from 2 Semester AY 2015-2016 to 2nd Semester AY 2018-2019.
nd

I am fully aware that my leave of absence has affected the regular status of my degree program.

Very truly yours,

BENJIE C. ALEJO

( ) Approved
( ) Disapproved

________________________
Dean

Date: _________________

TO BE ACCOMPLISHED IN 3 COPIES
- Dean’s Copy
- Registrar’s Copy
- Applicant’s Copy