Activity Request Form

ACTIVITY REQUEST FORM
Date Requested:
MonthDayYear
Date
Organization/College involved:
Direct contact:
Position:
Phone:
Email:
example@example.com
Other committee members or contributors (with contact info)
Program Title/Name:
Location of Program:
Duration of the Program:
Expected # of Participants:
Projected Budget:
(Attach budget proposal. See sample)
Source of Budget:
If sponsors, list down name of sponsors participating:
*Sponsors must be accredited with the Student Affairs Office (SAO
How much are you charging per student?
Is the payment compulsory or voluntary? If the amount charged to a student is above ₱ 100.00, submit a document where at least 75% of the target audiences affix their signature in agreement to the amount charged.
Type of Program / Activity
Type of Activity: (seminar, quiz bee, etc.)
Learning Goals/Objectives:
*Attach other available supporting documents (i.e. invitation, registration form, etc
The following should be submitted to the Office of Student Affairs, no later than 5 days after the event: 1) Liquidation of Expenses 2) Accomplished Evaluation (Provided by OSA) 3) 1-page narrative and a minimum of 5 attached photos with a short description 4) Attendance Sheet
Prepared by:
Adviser
College Dean
Head, Student Affairs Office
Director, Student Affairs Office
VP for Academic Operations
STUFO
Director, Student Affairs Office VP for Academic Operations
Should be Empty:

ACTIVITY REQUEST FORM