REQUEST FORM for REGULAR/ SPECIAL CLASS OFFERING Date: ________________Semester:_________________ School Year:_____________ Our department would like torequest for the offering of a special class () / regular class ()in__________________ a __________ unit subject with ______ lec units and _______ lab units. SECTION AND CLASS SCHEDULE: Section ___________ Day _______ Time ___________Room _______ Teacher____________________ I understand that this is not a regular subject offering and that the students who signed up on this list will be required by our Department to enroll in this subject.I had clearly explained to them that if this will not reach the minimum number of students set by the school (25 students during the regular semester and 15 students duringsummer), thesubjectwillbecategorizedasa specialclassandthatenlistedstudentswillbepaying the total cost equally divided to them.I have discussed the policies regarding the offering of a special/regular class with the enlisted students in the attached form, they are amenable to these and will abide accordingly. Requested/Endorsed to Dean for Approval: Total Number of Students: ______________ _______________________________________DEPARMENT/AREA/LEVEL CHAIR CBEAM/CIHTM/CEAS/CITE/CON/COL Approved/Endorsed to FRD for Computation _______________________________________DEAN CBEAM/CIHTM/CEAS/CITE/CON/COL Approved: _________________________________________ FRD MANAGER/REPRESENTATIVE Computed: Total Amount of the Class: Total Fee Per Student: APPROVAL TO ENROLL / OFFICIALLY START THE REGULAR / SPECIAL CLASS Approved for Room/ Schedule /Enrollment: _________________________________________ ROMANA LEVINIA B. SILVA Assistant Registrar for College Approved to Start the Class _________________________________________ RUBEN T. RUBIS Registrar

Form No. 11 J.P. Laurel National Highway, Lipa City 4217, Batangas, Philippines Tel. Nos. (043) 756-1849, 756-1887, 756-2391, 756-2491, 757-2011 Fax: (63-43) 981-1781. Official Web Site:http://www.dlsl.edu.ph OFFICE OF THE REGISTRAR 3 21 APPLICATION FOR SPECIAL CLASSSECOND SEMESTER OF SCHOOL YEAR 2013-2014 IMPORTANT:ALL STUDENTS WHO WILL SIGN ON THIS FORM ARE REQUIRED TO SUBMIT THE APPROVEDLETTER SIGNED BY THEIR PARENT & THE ADVISER. STUDENT NO. STUDENT NAMECONTACT NUMBERCOURSESIGNATURE 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. (if more than 25 students will enroll, please photocopy this page) POLICIES AND PROCEDURES IN THE OFFERING OF A SPECIAL CLASS: The students requesting for Special Class should proceed to the concerned Department/Area/Level Chair to request for the offering of the subject.Request should be processed after the issuance of grades. All grades of students should be complete for easier evaluation of records. The Department / Area / Level Chair processes and secures the approval of the Dean, the FRD Manager and the Registrar. PROCESS: 1.SecureandprocessFormNo.11RequestforRegular/SpecialClassOfferingForm.Formis available at the Office of the Registrar and is downloadable at the DLSL Website Registrars Page. 2.Secure the endorsement and approval of the College Dean regarding the opening of a Special Class or a Regular Class depending on the number of students. The Dean will identify the faculty who will handle the class. 3.Provide the students with the Letter to the Parent form if the request is a special class.For regular class, this form is not anymore required. 4.Coordinate with the assigned faculty for the final class schedule before informing thosewho will join the class to sign-in at the form.Classes should follow the standard schedule of classes. 5.Discusswithstudentsthatifincasetherequestedclasswillnotmeettherequiredclasssize, students will process the Letter with Parents Consent .Inform the students that advanced courses are not allowed to be opened. 6.DiscusswiththestudentsthatUPONTHEAPPROVALOFTHEAPPLICATIONFORSPECIAL CLASS, THOSE WHO SIGNED UP ARE CONSIDERED OFFICIALLY ENROLLED, WILL NOT BE ALLOWED TO DROP THE SUBJECT AND SHOULD PAY AT THE ACCOUNTING OFFICE.That any inquiry on this will be directed to the concerned Department/Area/Level Chair. 7.Present the application to the FRD Manager for computation of tuition and other fees based on the enlisted students. 8.Return the accomplished and approved form to the Office of the Registrar at least a week before the start of classes for official enrollment of students.9.Officially inform the Registrar for any change in the number of students, adding or dropping has to be officially processed. 10.Coordinate with the Registrar any concern that may arise during the course of the study This letter will be processed only if the requested class will not meet the required class size (15 for summer and 25 during the regular semester.Submit this to the assigned Curriculum and Evaluation In-Charge (Office of the Registrar) at the designated area for enlistment during the enrollment period. The RegistrarDate: _______________________ This Institution Dear Sir: Iwouldliketorequestfortheinclusionofmyson/daughtersnameintheSpecialClassRequestthis SECOND semester of school year 2013-2014. Iunderstandthatiftheminimumclasssizeof25studentsduringtheregularsemesteror15studentsfor summer will not be met, my son/daughter and the rest of the students enrolled in this subject will shoulder the tuition and other fees i.e. the total fees for the subject should be equally divided and appropriately charged to the enlisted students. Iamawarethatmyson/daughterisnotallowedtodropthissubjectandpaymentwillbeautomatically chargedtomysons/daughtersaccount.Iamalsoawarethatifhe/shewillnotattendthisclass,my son/daughter will be given a failing grade of 5.00 and such will be recorded in his/her Transcript of Records. My son/daughter has already received his/her latest semesters final course grades and based on this grade reporthehasnotaccumulated21unitsoffailurefora4-yeardegreeprogramand26unitsfora5-year degreeprogram.Iamawarethatifmyson/daughterhasexceededthemaximumallowableaccumulated units of failures, he/she will be automatically excluded from the list and will be dismissed by the school. My son/daughter informed me that he/shehas taken the pre-requisite of thissubject and that thisis part of his/hermaximumload;thathe/shewillnotcarrymorethanwhatisrequiredofhis/hercurriculum.Incase thereisaneedtotakethissubjectasanoverload,he/shewillseektheapprovaloftheCollegeRegistrar otherwise, he/she will be forced to drop the subject. My son/daughter will coordinate with the Department / Area / Level Chair for any update on this special class request including but not limited to tuition and other fees for this subject, payment schedule, class schedules and room assignments. That the school has the right to drop my son/daughter from this subject if he/she has found to have violated any of the rules and regulations of the school on enrollment of special classes. Conforme: __________________________________________________________________________ STUDENTS SIGNATURE OVER PRINTED NAMEPARENTS SIGNATURE OVER PRINTED NAME Contact Number: _______________________Contact Number : ________________________ Evaluated and Recommended for Approval: Approved: ACADEMIC ADVISERDEPARTMENT/AREA/LEVEL CHAIR SIGNATURE OVER PRINTED NAMECBEAM/CIHTM/CITE/CEAS/CON Verified and Encoded in the System ENROLLMENT & EVALUATION IN-CHARGEDate: _________________ J.P. Laurel National Highway, Lipa City 4217, Batangas, Philippines Tel. Nos. (043) 756-1849, 756-1887, 756-2391, 756-2491, 757-2011 Fax: (63-43) 981-1781. Official Web Site:http://www.dlsl.edu.ph OFFICE OF THE DEPARTMENT / AREA / LEVEL CHAIR DE LA SALLE LIPA