Fm-Reg-24 - Application - For - Graduation (Final)

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OFFICE OF THE UNIVERSITY REGISTRAR

1/F Administration Building


Visca, Baybay City, Leyte, 6521-A PHILIPPINES
Telefax: +63 53 563 7067 or 565 0600; Local 1010
Email: [email protected]
Website: www.vsu.edu.ph

APPLICATION FOR GRADUATION FORM

_October 07, 2022__


Date

The University Registrar


Visayas State University
Visca, Baybay City, Leyte 6521-A

Through: The Dean


College of __________
/Graduate School Dean
Sir/Madam:

I have the honor to apply for graduation as of October 07, 2022 for the
degree of Master in Agricultural Development (MagDev) major in
Agricultural Education .

Very Truly Yours,

JOSEPHINE G. TEOFILO 19-2-00022


Printed Name and Signature of Applicant Student Number

09615598220 N/A [email protected]


Cell phone Number Telephone Email Address

A. Title of [ ] Thesis [ ] Case Study [/ ] Special Problem [ ] Field Practice [ ] Narrative Report

FACTORS IDENTIFICATION IN SENIOR HIGH SCHOOL TRACK PREFERENCE OF SELECTED GRADE 9 AND
GRADE 10 STUDENTS OF BAYUGAN NATIONAL COMPREHENSIVE, BAYUGAN CITY, AGUSAN DEL SUR PHILIPPINES

B. Secure approval from your Thesis/Case Study/Special Problem/ Field Practice/ Narrative Report Adviser.

C. Subject(s) enrolled this (current) semester:

Course Number and Description Units Course Number and Description Units

AGED 290 SPECIAL PROBLEM 2

D. Subjects with INC grades, GNS, not yet taken or to be enrolled next term (to be filled by the course in-charge)

Course Number and Description Unit

Vision: A globally competitive university for science, technology, and


environmental conservation. Mission: Development of a highly
competitive human resource, cutting-edge scientific knowledge and
innovative technologies for sustainable communities and environment.
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No.
E. Secure Approval from your College Dean/Graduate School innovative technologies for sustainable communities and environment.
Dean

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Vision: A globally competitive university for science, technology, and
No.
environmental conservation. Mission: Development of a highly
competitive human resource, cutting-edge scientific knowledge and
PERSONAL DATA SHEET OF APPLICANT FOR GRADUATION
(Please print all entries in capital letter)

Student Number: 19-2-00022


Name: TEOFILO JOSEPHINE GAVIOLA
Family Name First Name Middle Name
If you are a married woman, write your maiden name: N/A

Age: 45 Sex: FEMALE Religion: R. CATHOLIC Citizenship: FILIPINO Date of Birth: 23 Oct. 1977
Place of Birth:Bayugan, Agusan del Sur Civil Status: Single
Home Address: H and N Inland Resort, Purok 7, Bobon, Butuan City Agusan del Norte
Barangay/Street Town/City Province
Name of Father: ROGELIO TEOFILO Citizenship: FILIPINO Occupation:FARMER
Name of Mother:SILVERIA M. GAVIOLA Citizenship: FILIPINO Occupation: HOUSEWIFE
Parent’s Address: Lot 4, Blk. 22, Bayugan Urban Poor, , Purok 8, Sta. Irene, Bayugan City, Agusan del Sur
If Married, Spouse (husband/wife) Name: N/A Occupation: N/A Spouse Address: N/A

SCHOOL RECORDS
Name of School Address of School School Year Honors or
Distinctions
Received

Elementary Sinadyap Elem. School Sta. Teresita, Bayugan, Agusan del 1989-1990 First Honor
Sur

Secondary Bayugan National High Poblacion, Bayugan City, 1993-1994 None


Comprehensive Agusan del Sur
School

Tertiary CARAGA STATE UNIVERSITY Ampayon, Butuan City 1998-1999 None


(formerly Northern Mindanao
State Institute of Science and
Technology )

Teaching Father Saturnino Urios Butuan City, Agusan del Norte 2018 None
Certificate University
Program

Trainers Northern Mindanao Matabao, Buenavista, 2018 Outstanding


Methodology School of Fisheries Agusan del Norte Trainee

Graduate Education (for Graduate Students only)

Visayas State University Master in Baybay, Leyte 2019 til


Agricultural Development Major in present
Agricultural Education

Membership in Organizations: None

I swear that all entries contained in this application for graduation are true and correct to the best of my knowledge
and belief.

JOSEPHINE G. TEOFILO _October 07, 2022_


Signature of Applicant Date

Distribution of copies: 1-College Dean and 1-University Registrar


competitive human resource, cutting-edge scientific knowledge and
innovative technologies for sustainable communities and environment.
Page 3 of 3 FM-REG-24 v1 06-30-2020
Vision: A globally competitive university for science, technology, and No.
environmental conservation. Mission: Development of a highly

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