Certificate Request Form

Page 1 of 4

Section 1

I. General Information

All transcript requests must be made by the student himself, either in person or in writing by letter, or email. Subsequent legal documents will be subject to a minimum fee of 100 pesos, payable in advance by cash. Requests should be made in timely fashion (at least two weeks in advance). Requests will only be entertained during office hours Monday to Friday.

II. Instructions

Accomplish the form below and we will automatically generate your request.

Pay the corresponding fee to Word of Life Bible Institute.

Applicant will incur the mailing cost and other fees such postal fee and other delivery fees.

III. Reminders

Applicants must claim their documents personally. Should they be unable to do so, they may send authorized representatives who may claim on their behalf. Authorized representatives must submit (1) an authorization letter from the applicant, (2) photocopy of applicant’s valid ID bearing his/her signature, and (3) representative’s own valid ID with signature.

All unclaimed legal documents will be disposed after six (6) months from the scheduled date of release.

Section 2: Personal Information

General Instructions Section:

"Please fill out the form completely and accurately. Ensure all information provided is correct to avoid delays in processing your request."

1. Full Name

First

Middle

Last

2. Contact Number*

3. Email address*

4. Mailing Address

(Current address or where the documents will be sent, if necessary. Format: Street address, city or town, principal subdivision such as province, state, or county, and postal code, country.)

Section 3: Academic Information

1. Program/s Attended/Inclusive Year Attended

(Kindly follow this format example: SBS, 2012; SMS, 2013)

2. Year Graduated

(Please indicate the year and the program. (e.g. SBS 2018, SBS 2019)

Section 4: Certificate Details

1. Type of Certificate Requested*

(Select one or more options)

Good Moral Certificate

Honorable Dismissal

Certificate of Enrollment

Others (Please specify)

Please specify the type of certificate you need:

2. Reason for Request*

(Provide a brief explanation, e.g., for school application, employment, or other purposes)

3. Deadline for Submission

(Date you need the document by)

4. Preferred Method of Receiving the Document*

Section 5: Certificate Details

1. Name of Institution or Organization (if applicable)

(For whom the certificate is intended)

2. Special Instructions or Requests

(e.g., specific details to be included in the certificate)

Section 6: Acknowledgment

Acknowledgment Statement*

“I confirm that the information provided above is true and correct. I understand that any false or incomplete information may cause a delay in processing my request.”

I agree.

This field should be left blank