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LOYOLA SCHOOLS FORM ADAA-4 (rev. 03-2015)
Ateneo de Manila University
Loyola Schools
OFFICE OF THE ASSOCIATE DEAN FOR ACADEMIC AFFAIRS
CONFIDENTIAL
(Standards Committee Use Only)
APPEAL FOR PROBATION
(for Incoming SY 20____ - 20____)
NAME: ________________________________________________
(Print) Surname
First Name
M.I.
CURRENT YEAR LEVEL: (Encircle)
I
II
III
IV
V
ID NUMBER: ___________
COURSE: ____________________
Address: _________________________________________ Tel./Mobile No. _____________
_________________________________________
Name of Father: ________________________ Name of Mother: _______________________
Note: If you have previously been on probation in the Ateneo de Manila University
Loyola Schools, you are INELIGIBLE to apply for probation.
Attach to this form a letter addressed to the Standards Committee explaining your
answers to the following questions:
1. What were the two/three most important reasons why you failed to meet the
required yearly QPI last school year?
2. Why do you think you deserve to be given another chance to continue your
studies at the ADMU Loyola Schools?
In your appeal, it is important to the Committee that you make clear serious reasons
beyond your control, if there are such reasons, to explain why you did not meet the
required yearly QPI.
________________________________________
Student’s Signature over Printed Name
_________________
Date Submitted
---------------------------------------------------------------------------------------------------------------------------Action of the Standards Committee:
________________________________________
Chair, Standards Committee
_________________
Date