Waiver

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Parents / Guardians Certification of Consent / Waiver

This is to certify _______________________________________________ to go on educational field trip on Oriental,Philippines.

that

am

allowing

my

son/daughter

(Name of student) January 25-27,2012 Iligan City-Misamis

I understand that this trip is in line with the requirements in the major courses listed below, and I acknowledge and fully support my son/daughters exposure to actual power and industrial plants, electronics companies, communications installation, and other establishments that are relevant to his pursuit of becoming an electrical and/or electronics and communications engineer. I am aware that the financial contribution to cover expenses for the entire trip is (Two thousand and five hundred pesos) P2500.00. It is understood that he/she abides by the rules and regulations that may be imposed by the Faculty-in-Charge / Chaperons for his welfare and safety. I fully agree to waive any responsibility on the part of the Mindanao State University and/or its representative/s, in case of any untoward incident that may happen to my son/daughter during the duration of the trip. Signed this ____________ day of _____________________, 2011. _________________________________________ Name and Signature of Parent/ Guardian Estimated Budget Transportation Approximately 440km 85x2 km +35x2 km +200 km . 25L/km*440km*P50/L=P550 Approx.. P200.00 each

Accommodation 350*2 nights= P700.00 each for 2 nights Food Day 1 L.D Day 2 BLD Day 3 BLD Miscellaneous 8 meals* P100/meals = P800.00

P800.00 TOTAL: P2500.00-Transportation+Accomdation+Food+Misc OVCAA Field Trip (FT) Form I Name of Faculty 1. Prof. Arthur Mioza 2. Engr. Rohanni MangorsiSumagayan 3. Prof. Karla Madrid-Khalid Subject EE 181 ECE 191 Signature Remarks

Name of Student: ____________________________________________ Purpose : ____________________________________________

Date

: ____________________________________________ ITINERARY Day Activity Departure- Marawi to Iligan NPC Holcim Pillsbury Asia Brewery CDO ABS-CBN CEPALCO Coca-Cola Company Mechatronics Lab and MUST Nestle STEAG Time 7:00 am 8:00-10:00 am 10:00-12:00 noon 12:00-1:00 pm 1:00-3:00 pm 3:00-5:00 pm 5:00pm 8:00-10:00 am 10:00-12:00 noon 12:00-1:00pm 1:00-3:00 pm 3:00-5:00 pm 8:00-10:00 am 12:00-1:00 pm 1:00-3:00pm

Day 1 AM Lunch PM Day 2 AM Lunch PM Day 3 AM Lunch PM

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