PRACTICUM: REQUEST FOR EXTENSION

COR JESU COLLEGE

_________________ PROGRAM
DIVISION OF BUSINESS AND ACOUNTANCY

Date Requested:
_________________
Name: ____________________________Course/Yr. /Sec.: _______________
Reason/s for Extension:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________
Company Name: _____________________________Tel-Num: ____________
Address:______________________________________________________________________________
______________________________________

Immediate Job Supervisor: _________________________________________

Inclusive Dates of Hours Rendered: From: ______________To: _____________
Total Hours Completed: ___________________ Hrs.

Target Date of Completion: _________________

____________________ ____________________
Student’s Signature Practicum Adviser

Approved By: Noted By:

_____________________________ James S. Apolinar, CPA

Practicum Coordinator Division Chairperson

Note: To be accomplished within 3 days from the date of request.

Cc: Instructor, Student.