INSTITUTE of ELECTRONICS

ENGINEERS of the PHILIPPINES, Inc.

WESTERN VISAYAS CHAPTER
(IECEP-WVC)
The Only Recognized Accredited Professional Organization of Professional Electronics Engineers,
Electronics Engineers and Electronics Technicians by the
Professional Regulations Commission of the Republic of the Philippines.
PRC Certificate Accreditation No. I-APO-05

AGREEMENT & OFFICIAL ENTRY FORM

Date _________________________

This is to confirm that we have read, understood and have agreed to abide by the ANNUAL REGIONAL
ELECTRONICS ENGINEERING INTER-SCHOLASTIC QUIZ SHOW RULES AND REGULATIONS.

__________________________________________ __________________________________________

SCHOOL/COLLEGE/UNIVERSITY Dean, School/College/University

Team Members (Please print complete name & sign and submit a 1x1 picture with names at the back)

1. ____________________________________ 4. ___________________________________

2. ____________________________________ 5. ___________________________________

3. ____________________________________ 6. ___________________________________

We certify that the above names are bonafide students enrolled in the 3 rd, 4th, and 5th year classes in our
School/University.

_______________________________________ _______________________________________

Coach’s Printed Name and Signature ECE Department Head Printed Name and Signature

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I hereby endorse the above names as official representative of their college/university to the Annual
Regional Electronics Engineering Inter-Scholastic Quiz Show.

Checked and Verified by: Noted by:

_________________________________ _________________________________

ENGR. BILLY JOHN J.DIMAJIVA ENGR. VICE N. MENDOZA

Vice Governor for Education, IECEP WVC Governor, IECEP-WVC