STUDENT REFERRAL PROGRAM FORM

Please print and fill out the form then email the clear scanned copy to [email protected] with
the email subject STUDENT REFERRAL PROGRAM FORM 2021.

Date:

Name of New Student:

Grade/Year Level: Program:

Contact Number:

Signature:

Referred by:

Grade/Year Level: Program:

Contact Number:

Signature:

I hereby authorize the University of Perpetual Help to collect, process, and use the information for legitimate purposes, including but not limited to answering
inquiries, and allow authorized personnel to process the information, store, save, secure, and protect database, and destroy the same in accordance with the laws,
rules and regulation.

Validated by:

Alabang-Zapote Road, Pamplona, Las Piñas City, 1740 Philippines • Tel. No.: (02) 8871-0639
www.perpetualdalta.edu.ph
Las Piñas Campus
 STUDENT REFERRAL PROGRAM TERMS & CONDITIONS
Binding Agreement. By participating in the Referral Program, you (the “Referrer”) agree to abide by
these UPHSD Referral Program Terms & Conditions.

Privacy. The personal information collected, processed and used as part of the Program will be used in
accordance with University's Data Privacy Policy.

Definition of Terms:

1. Referrer: All currently enrolled students (Basic Education and College) of University of
Perpetual Help System Dalta Campuses and incoming new students or transferees for the
Academic Year 2021-2022.

2. Referred Students: a friend or relative who has not previously enrolled with University of
Perpetual Help System Dalta and to whom the Referrer refers for enrollment. A “friend” is a
person with whom you communicate frequently and have met in person before. A
“relative” is a person with whom you are related other than siblings. The UPHSD Referral
Program is not applicable for sibling students.

Eligibility:

3. To be eligible for the UPHSD Referral Program, you must be enrolled as student of
University of Perpetual Help System Dalta.

4. In order to participate in the UPHSD Referral Program, students must fully accomplish the
Student Referral Program Form with complete and valid contact details of their referral.
After completion, submit the said form to the Marketing Office. Note that the UPHSD
Marketing staff will get in touch with you nominated referral to discuss their study options
with University of Perpetual Help System Dalta

5. By signing and submitting the form, the referrer signifies agreement to these terms and
conditions of the UPHSD Referral Program.

Eligible Referrals:

6. For the referred friend to qualify as an Eligible Referral of the UPHSD Referral Program, the
referred friend/relative must:
a. not be an existing student of University of Perpetual Help System Dalta;
b. not be a scholarship recipient
c. not have previously applied for any program for enrollment prior to the referral
 STUDENT REFERRAL PROGRAM TERMS & CONDITIONS
d. must mention your name during the phone/in-person/on-line application process as
a result of your referral
e. Enroll in any University of Perpetual Help System Dalta programs;
f. Referred students must enroll in campus where referrer is enrolled.
g. Referrals shall be considered valid upon completion of enrollment by the referred
students.

Referral Incentives:

7. University of Perpetual Help System Dalta shall credit the applicable discounts to the referrer
according to the following discount matrix.

No. of Referral Incentive Equivalent

8. University of Perpetual Help System Dalta will credit corresponding referral discounts only
after the referred student has made payment to complete his/her enrollment.

9. In case that the referred student has opted to avail of the installment payment scheme,
referral incentive shall also be credited in installment.

10. For cases of “3 enrollee referrals” where the referrer is supposed to receive 100% Discount
on Tuition and Miscellaneous Fees, a fraction of 25% of the referred students’ downpayment
shall be applied to the referrer as his/her initial payment for enrolment. Thus, same principle
shall be applied for the succeeding installments throughout the academic term.

11. The referral program shall be considered invalid if the referred student/s drops or withdraws
enrollment within the academic term.

12. Accounting Department shall apply respective discounts to the referrer once referred
accounts has been fully verified.

Conditions of UPHSD Student Referral Program:

13. This UPHSD Student Referral Program may not be entered into, or used in conjunction with
any other promotion.
 STUDENT REFERRAL PROGRAM TERMS & CONDITIONS

14. Students warrant that the individuals they intend to refer for the UPHSD Referral Program
meet the eligibility criteria outlined in these terms and conditions.

15. University of Perpetual Help System Dalta reserves the right, at any time, to verify the
validity of referrals and applications (including a referrer’s or applicant’s identity, age and
place of residence) and to disqualify any referrer or applicant who submits a claim or entry
that is not in accordance with these terms and conditions or who tampers with the claim or
entry process.

16. Referral admissions are subject to the university admission and assessment policies &
procedures.

17. University of Perpetual Help System Dalta reserves the right to change the UPHSD Referral
Program or the referral award structure at its discretion. Consequent referral program
changes will apply to all referral awards after such changes are made, even for users
referred prior to the changes.

18. University of Perpetual Help System Dalta retains the right to terminate the program at any
time at its discretion.

19. Terms and conditions will be revised for each new academic year. Any additional changes
will be published by University of Perpetual Help System Dalta website.

I have read and fully understand the contents of this document. I agree to the terms and conditions
stated above.

Printed Name:

E-mail Address:

Signature:
(signature of student or legal guardian of student under age18)

Date: