Student’s Copy

Guidance & Counseling

Far Eastern University
Manila

STAR Program Waiver

Mesdames and Sirs:

I, Clyde Kristofferson M. Saul a student of the Institute of_________________ with a Program under
____________ of this University, and with student number 2017841621, hereby state that:

1. I acknowledge that on _____________, I was issued by Guidance & Counseling temporary clearance,
given the fact that I commit to attend all modules of STAR Program of the Guidance & Counseling Office
as University intervention program under Student Retention Policy; and

2. I have to attend and render the following:

a. ___ number of seminar(s)/activities in lieu or in replacement of my non-attendance to the STAR

Program Modules that I missed last semester.

b. That the following seminar/activities that I shall render will be from the following Guidance &
Counseling Program like PEER Activities, Drug Abuse Prevention Core Group (DAPCG)
Program, Anti-Bullying Core Group (ABCG) Program and Children of OFWs Support Program
(COSP) during the Activity Periods of the 1st semester of AY 2019-2020.

c. That I will be issued certificate(s) of attendance that I will submit to my assigned counselors to
comply with the requirement.

____Clyde Kristofferson M. Saul____

Name of Student with Signature
Date: ____________________________
Mobile Number: ____09162273330___
Email add: _clyde_saul1@yahoo.com__
Attested by: _______________________________
Guidance Counselor with Signature
FEU/A-G&C-QSF.36 Rev. No.:00 Effectivity Date:3 January 2018
________________________________________________________________________________________________________________________

G&C’s Copy

Guidance & Counseling

Far Eastern University
Manila

STAR Program Waiver

Mesdames and Sirs:

I, Clyde Kristofferson M. Saul, a student of the Institute of_________________ with a Program under
____________ of this University, and with student number 2017841621, hereby state that:

1. I acknowledge that on _____________, I was issued by Guidance & Counseling temporary clearance,
given the fact that I commit to attend all modules of STAR Program of the Guidance & Counseling Office
as University intervention program under Student Retention Policy; and

2. I have to attend and render the following:

a. ___ number of seminar(s)/activities in lieu or in replacement of my non-attendance to the STAR

Program Modules that I missed last semester.

b. That the following seminar/activities that I shall render will be from the following Guidance &
Counseling Program like PEER Activities, Drug Abuse Prevention Core Group (DAPCG)
Program, Anti-Bullying Core Group (ABCG) Program and Children of OFWs Support Program
(COSP) during the Activity Periods of the 1st semester of AY 2019-2020.

c. That I will be issued certificate(s) of attendance that I will submit to my assigned counselors to
comply with the requirement.

____Clyde Kristofferson M. Saul____

Name of Student with Signature
Date: ____________________________
Mobile Number: ____09162273330___
Email add: _clyde_saul1@yahoo.com__
Attested by: _______________________________
Guidance Counselor with Signature
FEU/A-G&C-QSF.36 Rev. No.:00 Effectivity Date:3 January 2018