UNIVERSITY OF NEGROS OCCIDENTAL-RECOLETOS

51 LIZARES AVENUE, BACOLOD CITY, NEGROS OCCIDENTAL

OFFICE OF THE DIRECTOR OF

STUDENT AFFAIRS

Student Organization Activity Form for Online Approval

(send this form to dexterpauldioso@uno-r.edu.ph after filling-out the form)

ORGANIZATION: Xxxxxxxxxxxxxxxx

CP Number: Xxxxxxxxxxxxxxxxxx Budget: Php xxxxxx

ACTIVITY TITLE: Xxxxxxxxxxxxxxxx

Date: Xxxxxxxxxxxxx Day: Xxxxxxxxxxxxxx

Time : Xxxxxxxxxxxx

Media Platform to be used: Xxxxxxxxxxxxx

Details / Notable Information ( if any)

Xxxxxxxxxxxxxxxxxxxx

Learning Outcomes: At the end of the activity, the students will be able to:

1. Xxxxxxx
2. Xxxxxxxxxxxx
3. Xxxxxxxxxxxxx

Target Core Value/s:

1. Xxxxxxxxxxxxxxxxx
2. Xxxxxxxxxxxxxxx

Prepared by: Xxxxxxxxxxxxxxxxxxxx

SSG/ Governor/Campus Organization President

Once this form is sent to the Office of the Director of Student Affairs, it is presumed that the
above signatory has consulted the other officers of the organization, and once permitted to do so, shall
pass the resolution of this activity with signatories as needed by the document.

--------------------------------------------------For DSA Use Only-----------------------------------------------

Attachment for the pre-approval of the adviser and the Dean or Campus Ministry Director. The DSA
Office shall communicate to the adviser and Deans/Head concerned, and after their response shall return
this form either approved, disapproved, or revised for approval.
Approved by:

__________________________________
Dexter Paul D. Dioso, PhD, CSASS
Director of Student Affairs