University of San Jose-Recoletos
Magallanes St., Cebu City 6000 Philippines
OFFICE OF THE REGISTRAR
– JURIS DOCTOR CONFERMENT –
APPLICATION FORM
Date Applied : ______________________________ Date of Conferment: ______________________________
PERSONAL INFORMATION:
Name : _________________________________________________________________________________________________
(Family Name) (First Name) (Middle Name)
(For married female applicants, please indicate below complete Maiden Name and submit a photocopy of marriage contract.)
Name : _________________________________________________________________________________________________
(Family Name) (First Name) (Middle Name)
Year Graduated from Bachelor of Laws (LlB): _____________________________________________________________
Date of Birth : _______________________ Place of Birth: _____________________________________________
mm/dd/yyyy
Parent/Spouse : ______________________________________________________ Civil Status: ________________
Undergraduate Degree : ______________________________________________________________________________________
Current Address : ______________________________________________________________________________________
Office Address : ______________________________________________________________________________________
Contact Number(s) : ______________________________ E-mail Address: ____________________________________
____________________________________________
Signature of Applicant
Signature of the office in-charge:
____________________________________ ____________________________________
Dean, School of Law Accounting
NOTE:
1) The accomplished application form must be submitted to the Registrar’s Office together with a photocopy
of the marriage contract (for married female applicants) not later than September 28, 2019 (Saturday).
2) Kindly accomplish the Data Privacy Consent Form found on the reverse side of this application form,
otherwise, processing of the application will be cancelled.