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UPCP Return Service Agreement (RSA) Online Monitoring Form
This form is solely dedicated for the efficient monitoring of FORMER STUDENTS OR GRADUATES of the UP College of Pharmacy (UPCP) who are covered under the Return Service Agreement (RSA) Program. This program has been implemented to UPCP students, shiftees, or transferees who had been admitted to the university starting the year 2011.

Please allot 15 minutes to answer this form. Everyone who is covered under the program is REQUIRED to accomplish this form AT LEAST ONCE ON OR BEFORE DECEMBER 31 OF EVERY YEAR until the RSA is completely served - beginning from the year the student has graduated, up to a maximum of five (5) years.

Other necessary documents may be requested to validate the information provided in this form.

Information obtained through this medium will be kept confidential. Should you have any concerns regarding the program, you may approach the College Secretary or the UPCP RSA Coordinator for assistance.


- UP College of Pharmacy Return Service Agreement Committee

Email address *
Year of Graduation (yyyy) *
For NON-GRADUATES who are covered under RSA, write RSA-(year of last attendance to the college.) - e.g. RSA-2016.
Your answer
Student Number *
(e.g. 2011-12345)
Your answer
Degree Program *
Complete Name (Surname, First Name M.I.) *
(e.g. Loquias, Monet M.)
Your answer
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