0000
Date:   
MIRIAM COLLEGE FOUNDATION, INC
Katipunan Road, Loyola Heights
Quezon City, 1108, Philippines
TIN No. 000-720-573-0000 NON VAT
Registration Assessment Form
Student ID: Bank Reference Number:
Name:
Year Level:  Course: 
Gender:  Nationality: 
Birth Date:  Birth Place: 
Civil Status: Religion: 
Tel. No.:  Mobile No.: 
Address:
Father's Name:  Contact No.:
Occupation:  Business Address: 
Mother's Name: Contact No.:
Occupation: Business Address: 
Tuition and Fees:
  Total Assessment: 0.00  
Payment Due Date:
Note:
• Use the Bank Reference No. when paying online via Bancnet.
• Transfer or Withdrawn Students:
A student who transfers or otherwise withdraws in writing for whatever reason, shall be charged tuition and other school fees in accordance with the 2008 Manual of Regulations for Private Higher Education Article 20, Section 100 as shown below:
  % of Total Payable for the School Year
  TUITION FEE BASIC FEES MISC. FEES
If the student transfers or withdraws within the 1st week of classes, whether attended or not 25% 25% 25%
If the student transfers or withdraws after the 1st week of classes, but within the 2nd week of classes, whether attended or not. 50% 50% 50%
If the student transfers or withdraws after the 2nd week of classes whether attended or not 100% 100% 100%
BIR Permit No. Issued on
UserName
By enrolling my child at Miriam College, I agree to abide and be bound by all school rules and regulations. Upon affixing my signature, I confirm that I have read and fully undrestood the School Policies stated.



____________________________________________
Signature of parent or guardian over printed name


Date: _________________________
Tuition and other fees may be paid in cash, by check or credit card. These fees can be paid in full or through the school’s prescribed installment plans. The first instalment payment (upon registration) fees must be paid in full not later than June 21, 2014 to be considered officially enrolled. Unpaid registration transactions will automatically be voided.