Date and Time Submitted Student Copy Date and Time Submitted VSB Copy

Tear half and keep this side for future reference. Tear half and submit this side to RVC or VSB Room 105 for filing.
UNIVERSITY OF THE PHILIPPINES UNIVERSITY OF THE PHILIPPINES
CESAR E.A. VIRATA SCHOOL OF BUSINESS CESAR E.A. VIRATA SCHOOL OF BUSINESS
Diliman, Quezon City Diliman, Quezon City

WAIVER OF PREREQUISITE REQUEST FORM WAIVER OF PREREQUISITE REQUEST FORM

► Submit this form together with your Plan of Study (POS). ► Submit this form together with your Plan of Study (POS).

Term  1st Sem  2nd Sem  Midyear AY 20____ - 20____ Term  1st Sem  2nd Sem  Midyear AY 20____ - 20____

First Middle Last First Middle Last

Name Name Name Name Name Name
Student Number - Student Number -
Email Address Cell / Tel. No. Email Address Cell / Tel. No.

 1st  2nd  BSBA  BSBAA  1st  2nd  BSBA  BSBAA

Year  3rd  4th Course Year  3rd  4th Course
 Others ________________  Others ________________
 5th  5th
Prereq Signature Prereq Signature
Section and Section and
Subject Subject of the Instructor that the Subject Subject of the Instructor that the
Grade Semester Grade Semester
to Take Requesting Student has Fully to Take Requesting Student has Fully
Taken Taken
Waiver Attended the Course Waiver Attended the Course

I hereby certify that all the information stated above are correct and I hereby certify that all the information stated above are correct and
that I will take the prerequisite/s simultaneously with the course or that I will take the prerequisite/s simultaneously with the course or
immediately in the next semester. immediately in the next semester.

Signature: ___________________ Signature: ___________________

APPROVE DISAPPROVE Date APPROVE DISAPPROVE Date

Instructor of the Instructor of the
Subject to be Taken Subject to be Taken

Department Chair Department Chair

College Secretary College Secretary