UPLB-OCS Form No.

105
COLLEGE OF AGRICUTURE
UNIVERSITY OF THE PHILIPPINES

Application for Revision in the Approved Plan of Course Work1

Department/Institute

(NOTE: Application for revision should be made before the course to be deleted, added
or replaced is registered, and that the change is not due to a failing).

Please check the appropriate Change in Major Field/ Specialization

box(es): Change in Major Option (thesis, practicum, all
course, etc.)
Change in Major Course or Subject **
Change in Elective**
Change in Major Adviser
Change in GE

N Degree/Cour BS Click here to enter

ame: Click here to enter text. se: text.
Major
Student No: Click here to enter text. Field: Click here to enter text.
Approved Proposed Change
Major Field/ Option/ Major Course/ Major Field/ Option/ Major Course/
Elective/ Adviser Elective/ Adviser
1
. Click here to enter text. 1. Click here to enter text.
2
. Click here to enter text. 2. Click here to enter text.
3
. Click here to enter text. 3. Click here to enter text.
4
. Click here to enter text. 4. Click here to enter text.
Justification:
1 Click here to enter text.
.
2 Click here to enter text.
.
3 Click here to enter text.
.
4 Click here to enter text.
.
(use extra sheet if necessary)
Click here to
enter a date.
S Date
t
u

1
∗ Attach photocopy of approved plan of course work
**
** Indicate semester and year to be taken
**
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Recommending Approval:
Conform
e:
Click here to enter text.
Printed Name & Signature of Printed Name & Signature of
Adviser Date Adviser
(if applicable)
Click here to enter text.
Director/ Department Head Date

Approved:

Click here to enter text.

College Secretary Date