STI BALAGTAS
CHANGE OF GRADE FORM
Reminder: Any form of erasures will invalidate this form
This section is to be accomplished by the Faculty Member
STUDENT INFORMATION
Student Number
2000306198
Last Name
First Name
Middle Name
MONTEMAYOR,IYLE JHAVEY CORPUZ
School Year
2023 - 2024
Program Classification
 Graduate  Tertiary  Senior High School
Term:
 1st
 2nd
Grade/Year Level: 3RD YEAR
Class Number
Program Title/Strand
Course Code and Title
CTHC 1010 - BL61 Foreign Language 1
24011
BS HOSPITALITY
MANAGEMENT
CHANGE OF GRADE
From (Old Grade)
 Summer
To (New Grade)
5.00
3.0
JUSTIFICATION
Briefly explain the justifiable reason/s for the change in the student's previous grades. Please provide a list of the student’s grades in the
course and documentation of how the final grade was calculated specifically, grading criteria, class record, and old student grade form. For
class record, attach the Summary of Class Record for Tertiary or SHS Class Record.
Faculty Member’s Full Name and Signature
Date Requested
08/17/2024
Cate Norreine P.
Santiago
REQUIRED SIGNATORIES (Please ensure all fields required are completely filled out with supporting documents before signing.)
DESIGNATION
REMARKS
PRINTED NAME
SIGNATURE BASED ON STATUS
DATE
PROGRAM HEAD/
ASSISTANT
PRINCIPAL
ACADEMIC
HEAD/PRINCIPAL
MELISSA R.
AZARCON
ENDORSED
NOT ENDORSED
ENDORSED
NOT ENDORSED
ENDORSED
NOT ENDORSED
APPROVED
DISAPPROVED
ENDORSED
NOT ENDORSED
GRADES ARE POSTED
GRADES ARE NOT
POSTED
GRADES PRINTED AND
ISSUED TO STUDENT
GRADES ARE NOT
PRINTED AND ISSUED TO
STUDENT
REGINA
R. MAPE
SCHOOL
ADMINISTRATOR/
DEPUTY SCHOOL
ADMINISTRATOR
JESSIE
M. VERANO
SCHOOL
PRESIDENT/SCHOOL
DIRECTOR
KERWIN
C. KAW
ACADEMIC
OPERATIONS
MANAGER
STI HO ENCODER
REGISTRAR
FELICIANO
MONTEMAYOR
Change of Grade Form | FT-AOG-004-00