WAIVER FORM

Date:

______________

Name: ______________________________________
Address:
________________________________________________________________
________________________________________________________________
Contact No.: _______________________
Amount Paid: Php ___________________ OR No.: ______________________
In reference to the attached receipt, we hereby waive the corresponding amount from the
Review tuition fee.
The remaining outstanding balance is Php ________________.

FOR THE CENTER,

________________________________________
Authorized Persons Signature over printed name

WAIVER FORM
Date:

______________

Name: ______________________________________
Address:
________________________________________________________________
________________________________________________________________
Contact No.: _______________________
Amount Paid: Php ___________________ OR No.: ______________________
In reference to the attached receipt, we hereby waive the corresponding amount from the
Review tuition fee.
The remaining outstanding balance is Php ________________.

FOR THE CENTER,

________________________________________
Authorized Persons Signature over printed name