APPLICATION FOR GOOD MORAL CHARACTER CERTIFICATE
Application Details: For student’s use only
Date Applied	Click to enter a date.	Term Applied	Click here to enter text.
Academic Year applied	Click here to enter text.	Student No.	Click here to enter text.
Surname	Click here to enter text.	First Name	Click here to enter text.
Middle Name, if any	Click here to enter text.	Maiden Name, if married	Click here to enter text.
Program/Degree	Click here to enter text.	Major, if any	Click here to enter text.
Contact No(s).	Click here to enter text.	Email Address	Click here to enter text.
Reason for application	☐	Transfer to another school
☐	Scholarship
☐	Employment
☐	Further studies
☐	Others	Click or tap here to enter text.
Preferred Claiming Mode	☐	For Pick-up	☐ For Mail (courier services will not be shouldered by the school)
Assessment: For Accounting use only: Please send this form back to the students for assessment of fees. Please send to OSFAD once payment has been made.
☐ Cleared	Total Amount Due	Click or tap here to enter text.
☐ Not Cleared	Cleared/Assessed by	Click or tap here to enter text.
Authentication Code	Click or tap here to enter text.
Remarks (later use) ☐ Go ☐ No Go	Click or tap here to enter text.
Approvals: For OSFAD use only
☐ Approved	OSFAD Personnel	Click or tap here to enter text.
☐ Disapproved	Authentication Code	Click or tap here to enter text.
Date Evaluated	Click or tap to enter a date.
Remarks	Click or tap here to enter text.

Fill out the Application Details correctly and completely and send to plmaraccntng@gmail.com; Accounting Office for clearance and assessment of application. Wait for the approved application in your email. Once this application has been approved, please correctly and completely fill out and print the Order of Payment attached to this form. Schedule your date of payment using this link http://ums.plmar.edu.ph/quick-links/online-appointment-sched.aspx. Present the Order of Payment to the Cashier’s Office and pay your application on the scheduled date. Post your payment using this link https://bit.ly/2AxB8eX Wait for a confirmation message in your email regarding the scheduled release of your Certificate of Good Moral Character. In compliance with R.A. No. 10173 (DATA PRIVACY ACT OF 2012), representative must submit a signed authorization letter with original valid ID of both owner/student and representative upon claiming of the requested document(s).
For Accounting use only. Please fill-out the required information. Once the student receives this forms, he/she needs to print and cut all four (4) Orders of Payment and must present this to the Cashier’s Office.
PAMANTASAN NG LUNGSOD NG MARIKINA	PAMANTASAN NG LUNGSOD NG MARIKINA
Accounting Office	Accounting Office
Concepcion Uno, Marikina City	Concepcion Uno, Marikina City
ORDER OF PAYMENT	ORDER OF PAYMENT
Student No.	Enter details here	Student No.	Enter details here
Surname	Enter details here	Surname	Enter details here
First Name	Enter details here	First Name	Enter details here
Middle Name, if any	Enter details here	Middle Name, if any	Enter details here
Degree	Enter details here	Degree	Enter details here
Major	Enter details here	Major	Enter details here
Payment for	Certificate of Good Moral	Payment for	Certificate of Good Moral
Amount Paid	P 50.00	Amount Paid	P 50.00
Official Receipt No.	Official Receipt No.
Date Paid	Date Paid
Authorized by	Arvin Villodres	Authorized by	Arvin Villodres
PAMANTASAN NG LUNGSOD NG MARIKINA	PAMANTASAN NG LUNGSOD NG MARIKINA
Accounting Office	Accounting Office
Concepcion Uno, Marikina City	Concepcion Uno, Marikina City
ORDER OF PAYMENT	ORDER OF PAYMENT
Student No.	Enter details here	Student No.	Enter details here
Surname	Enter details here	Surname	Enter details here
First Name	Enter details here	First Name	Enter details here
Middle Name, if any	Enter details here	Middle Name, if any	Enter details here
Degree	Enter details here	Degree	Enter details here
Major	Enter details here	Major	Enter details here
Payment for	Certificate of Good Moral	Payment for	Certificate of Good Moral
Amount Paid	P 50.00	Amount Paid	P 50.00
Official Receipt No.	Official Receipt No.
Date Paid	Date Paid
Authorized by	Arvin Villodres	Authorized by	Arvin Villodres