OSAS-QF-25

Republic of the Philippines

CAVITE STATE UNIVERSITY
Don Severino Delas Alas, Campus
Indang, Cavite
 

STUDENT INFORMATION

Last Name First Name M.I. Sex Date of Birth

Mailing Address Student Number

Contact Number:
Academic
Name of Organization: Non-Academic
Name of Advisers In-Charge: Perfroming Arts

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PARENT / GUARDIAN PERMIT / CONSENT

This is to certify that I have full knowledge of and permission for my

son/daughter/foster child to join and participate in:

Title of Activity: PICE CvSU Orientation and General Assembly

Date and Time of Activity: August 30, 2019 (Friday) – 1:00 pm to 5:00 pm
Place of Activity: Cavite State University International Convention Center

I concur and agree on the rules, policies & regulations being implemented by the concerned
organizers.

Name & Signature of Parent/Guardian Contact number