UTPRAS Form 01

(Revised 01/15/2000)

APPLICATION FOR TVET PROGRAM REGISTRATION

________________________ Date DIR. TEODORO M. GATCHALIAN Regional Director Technical Education and Skills Development Authority III Government Center, Brgy. Maimpis City of San Fernando, Pampanga Through: Ms. Belinda A. Labutong, CEO VI Provincial Director San Isidro Industrial Complex, San Isidro, Tarlac City

Madame:

The undersigned the Camiling Colleges Inc. (Name of Institution) Gomez St. Camiling, Tarlac (Complete Address)

RODOLFO G. ROMULO (Head of Institution) ,a Private College

of (Position/Designation) located at

(Type of School/Institution) , hereby petition for registration of the

following courses/programs and offer under laws of the Republic of the Philippines.
Courses/Programs Duration Courses/Programs Bookkeeping Electrician Cosmetology Welding Wiring Installation Practical Electricity Auto Diesel Mechanic Business Entrepreneurship Computer Technology To support this petition are the following documents duly certified / authenticated: Duration

A.) Corporate and Administrative Papers 1.Notarized Letter of Application 2. Certified Board Resolution (Private Institution Only) 3.SEC Registration and Articles of Incorporation (Private Institution Only) 4.Title showing Ownership or Lease-Contract of at least five (5) Years 5.Certificate of Occupancy 6.Fire Safety Certificate 7. B.) Curricular Requirements 7. Curriculum (Indicating the job title(s) being addressed and the Competences to be Developed). 8. Course and subjects Description 9. List of Supplies, Tools and Equipment for the Program Indicating the Quantity, Specification, and Date of Purchase) 10. List of Instructional Materials (Books, Video Tapes, CDs, Internet Access, etc.) C.) Faculty and Personnel (with supporting documents) 11. List of School Officials and Qualifications 12. List of Faculty for the Program (Indicating their Qualification Teaching Assignment, Status of Appointment with supporting documents) e.g. Trainors Profile, Transcript of Records, Certifications, etc. 13. List of Non-Teaching Personnel and their qualifications D.) Academic Rules 14. Schedule of Tuition and Other Fees 15. Grading System 16. Entry Requirements 17. Rules on Attendance

UTPRAS Form 01
(Revised 01/15/2000)

E.)

Support Services 18. Health Services 19. Career Guidance/Placement Services 20. Community Outreach Program 21. Research Programs F.) Rodolfo G. Romulo (Head of Institution) , as Chairman / President (Position/ Designation) , promise to

Maintain the standards required to the courses / programs and to follow faithfully all laws, rules and regulations, and the requirement of the Technical Education and Skills Development Authority governing the operations of the courses/programs or any changes in the prescribed requirements. I acknowledge that the violation of the laws, rules and regulations of the Authority shall be deemed sufficient cause for the revocation of the authority granted. This institution will not conduct classed in the above courses/programs for until and unless this application be approved and the Technical Education and Skills Development Authority issue the corresponding Certificate. Very truly yours, RODOLFO G. ROMULO
(Signature over Printed Name) AFFIDAVIT Republic of the Philippines City / Municipality of ___________________) Province of ___________________________) I, _________________________________ of _________________________, of legal age, and a resident of the Philippines, after having been sworn to in accordance with the laws, depose and say that the information in this application and in the supporting documents are true and correct. SUBSCRIBED AND SWORN to before me this _______ day of __________. The affiants exhibited his/her Community Tax Certification No. ______________________ issued at __________________ on ___________________________.

Notary Public Doc. No. Page No. Book No. Series No. ______ ______ ______ ______