PROMISSORY NOTE
Date : August 08,2021
For value received, I/We promise to pay La Salle University or its order the sum of forty three thousand
six hundred forty two pesos only (P 43,642.00) on or before August.
(amount in words)
I/We understand and accept that my son/daughter/relative will not be allowed to enroll for the
succeeding term or to graduate for failure to pay the amount due for the term.
I/We certify that the information given on this note is correct and complete.
WELLINA JOY G. ALCOPRA MA. ANCILLA G. ALCOPRA
Signature over Printed Name Signature over Printed Name
APPLICANT PARENT ON-RECORD
ID NUMBER: 180846638
Contact #: 09108131699
Approved:
SHERRYL J. ORIGENES
Scholarship Coordinator