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Student Statement Form

Student Statement Form Template for Philippines

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Key Requirements PROMPT example:

Student Statement Form

"I need a Student Statement Form for a private university in Manila, Philippines, to be used for the 2025-2026 academic year, that includes special provisions for international students and must comply with CHED requirements for medical school admissions."

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Document background
The Student Statement Form is a fundamental document used across educational institutions in the Philippines to collect and verify student information and declarations. This form is typically required during enrollment periods, major academic transitions, or when specific student declarations are needed for institutional records. It ensures compliance with Philippine education laws, including RA 10533 and RA 10173, while providing institutions with necessary student information for administrative, academic, and legal purposes. The form typically includes personal information, academic declarations, truth statements, and privacy notices, making it an essential tool for maintaining accurate student records and ensuring regulatory compliance in Philippine educational institutions.
Suggested Sections

1. Student Information: Basic personal details including full legal name, student ID number, course/program, year level, and contact information

2. Parent/Guardian Information: Contact details of parents or legal guardians (required for minors and often for all students for emergency contacts)

3. Academic Declaration: Student's declaration regarding academic standing, enrollment status, and any academic commitments

4. Truth and Accuracy Statement: Declaration that all information provided is true and correct, with acknowledgment of consequences for false statements

5. Data Privacy Notice: Statement regarding the collection, use, and protection of personal information in compliance with RA 10173

6. Signature Block: Space for student signature, date, and witness signature if required

Optional Sections

1. Medical Information: Section for declaring medical conditions or special needs, used when the institution requires health information

2. Financial Declaration: Statement regarding financial obligations and scholarship status, used for students receiving financial aid or scholarships

3. Disciplinary Record: Declaration of any previous disciplinary actions, used for transfer students or specific institutional requirements

4. Extra-curricular Activities: Section for declaring participation in school activities, used when relevant to program requirements or institutional tracking

5. Special Accommodations: Section for requesting specific accommodations, used when student requires additional support or facilities

Suggested Schedules

1. Schedule A - Supporting Documents Checklist: List of required documents that must be submitted along with the statement form

2. Schedule B - Code of Conduct Agreement: Summary of key student conduct policies that the student acknowledges

3. Schedule C - Emergency Contact Form: Detailed emergency contact information and medical authorization

4. Appendix 1 - Institution-Specific Policies: Summary of relevant institutional policies referenced in the main form

5. Appendix 2 - Privacy Policy Details: Detailed explanation of how student data will be collected, used, and protected

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Linkedin in social icon imageX social icon image
alex.den.21@genieai.co
Clauses
Personal Information Declaration
Data Privacy Consent
Academic Status Declaration
Financial Declaration
Truth and Accuracy
Document Authenticity
Rules and Regulations Compliance
Medical Disclosure
Emergency Authorization
Confidentiality
Code of Conduct Acknowledgment
Records Access Authorization
Information Update Obligation
Institutional Policy Compliance
Parental Consent
Photography and Media Release
Liability Waiver
Disciplinary Record Declaration
Special Needs Disclosure
Document Submission Commitment
Relevant Industries

Education

Higher Education

Secondary Education

Technical and Vocational Education

Private Education

Public Education

Educational Technology

Educational Administration

Relevant Teams

Admissions

Student Affairs

Registrar

Compliance

Data Protection

Legal

Academic Administration

Student Services

Records Management

Academic Affairs

Relevant Roles

School Registrar

Admissions Officer

Academic Coordinator

Student Affairs Director

Compliance Officer

Data Protection Officer

Education Administrator

Enrollment Manager

Student Services Coordinator

Academic Records Officer

Department Head

School Principal

Dean

Academic Director

Legal Counsel

Industries
Republic Act No. 10533: Enhanced Basic Education Act of 2013 - Provides the framework for K-12 education and establishes requirements for student documentation and academic records
Republic Act No. 10931: Universal Access to Quality Tertiary Education Act - Governs aspects of tertiary education and related student documentation requirements
Republic Act No. 10173: Data Privacy Act of 2012 - Regulates the collection, handling, and protection of personal information, including student data
Republic Act No. 386: Civil Code of the Philippines - Particularly provisions regarding contracts and capacity of minors to enter into agreements
CHED Memorandum Orders: Various memoranda from the Commission on Higher Education that specify requirements for student documentation and record-keeping
DepEd Order No. 8, s. 2015: Policy Guidelines on Classroom Assessment for the K to 12 Basic Education Program - Includes provisions on student documentation and academic records
Republic Act No. 9155: Governance of Basic Education Act - Establishes the framework for basic education governance including student documentation requirements
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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