STUDENT Organization and Activities

Application for Accreditation

Organization profile Date Filed:

Should be accompanied with the following document:
a. List of Officers
b. List of members (if member are more than fifty, 50% Date Received:
may just reflected in the form)
c. Profile of the President
d. Adviser/s Consent Received by:
e. Action plan
f. Constitution and by Laws (for new)
g. Accomplishment Report with Financial Statement
(for renewal) Application Type:
h. Falsification of document/s or any forms of fraud _____ New _____
will result to cancellation of disapproval of the Renewal
application

Name of Organization:

Name/s of President: (Last Name, First Name, Middle Course/Year:

Initials) Contact#:

Name/s of Adviser/s: (Last Name, First Name, Middle College/Contact:

Initials)

1.
2.
3.
College (if with college affiliation) Total
Membership: __________
Male: ________________
Female: ______________

Organization Goals

SY: ____________________ Date of CBL Adaption:

I attest to the truth of the foregoing

_________________________________
President’s Signature Over Printed name

ESSU- OSAA - SOA -200 I Version 4 Page 1

Effectivity Date: June 10, 2021