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OFFICE OF TELECOMMUNICATION

Calip-Atienza Building Room205


Dimasalang corner Don Quijote Sts. Sampaloc, Manila 1008
(02) 516 2932 / telecom@stjude.edu.ph

FORM B
ACCOMPLISHMENT REPORT
Organizational
Campus Invitation

Council/Collegiate
Outreach Activity

In-Campus Invitation

Fund-Raising Institutional

Off-Campus Activity

Main Proponent:
________________________________________________________________________________________
Co-Proponent:
________________________________________________________________________________________
Title of the Activity:
________________________________________________________________________________________
Venue:
________________________________________________________________________________________________
Date of Activity (MM/DD/YYYY; Time started - ended):
________________________________________________________
Participant (Target; Actual):
________________________________________________________________________________
Expenditure (Estimated; Actual) Php
________________________________________________________________________
Name of Speaker (if any):
________________________________________________________________________________
Ranking/ Recognition/ Award(s) achieved (if any):
________________________________________________________
Accompanying Adviser/Faculty:
________________________________________________________________________
EVALUATION MARK (General Average):
________________________________________________________________________
Table No. 1 USE EXTRA SHEET FOR ADDITIONAL DETAIL(s).
Success indicators

Output

Off-

Table No. 2 USE EXTRA SHEET FOR ADDITIONAL DETAIL(s).


Problems Encountered
Solutions Made

Recommendation

Prepared by:
ATTACHMENT NEEDED:
Name: __________________________________
Position:
__________________________________Evaluation Report (from Organizing Committee

Summary of attendance
Printed 4-5 Copes of Picture or CD
Documentation

Important! Please attach photocopy of:


Copy of Financial Report (FS) for Fund-Raising
activity
Copy of after Activity Report (AAR) for Outreach

Noted by:
__________________________________________
Director
(Printed over printed name)

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