Ateneo de Zamboanga University PROGRAM-CHANGE
HIGHER EDUCATION UNIT FORM
Instructions: Accomplish this form in duplicate. After completing the shifting procedure, submit 1 form to your former
Home Department, and the other form to the Receiving Department. Note that shifting to another
program is subject to the program’s admission requirements.
Date: Semester:
School Year:
Name of Student: College:
ID No: Program:
Year Level:
To be filled out by the HOME Department
PROGRAM TO SHIFT TO:
REASON FOR SHIFTING:
APPROVED BY: NOTED BY:
DEPARTMENT CHAIR DEAN of COLLEGE/SCHOOL
To be filled out by the ADMISSIONS AND AID Office
GPA AND READINESS TEST FOR COLLEGES AND UNIVERSITIES (RTCU) QUALIFICATIONS
This is to certify that in so far as the previous semester GPA and RTCU score is concerned, the student is qualified for the program shift.
Previous Semester GPA:
RTCU Scores:
COMPOSITE
SCORE ENGLISH MATH SCIENCE
SCORE
STANDARD SCORE
STANINE
CERTIFIED BY:
DIRECTOR of COLLEGE ADMISSIONS AND AID
To be filled out by the RECEIVING Department
Date:
⃝ Accepted ⃝ Not Accepted
REMARKS:
APPROVED BY: NOTED BY:
DEPARTMENT CHAIR DEAN of COLLEGE/SCHOOL