PAMPANGA STATE AGRICULTURAL UNIVERSITY

Office of the President

CRISIS MANAGEMENT COMMITTEE

FORM B. ENDORSEMENT OF CRISIS MANAGEMENT COMMITTEE

DOCUMENTS PROVIDED

 Letter of intent from the faculty member addressed to the Office of the President
 List of participating students with their email addresses
 Notarized parental consent of the students
 Proof of insurance with COVID-19 coverage of the students
 Proof of full vaccination of the students and faculty member
 Approved Course Guide (for Category 2 and 3)
 Plan of Work (for Co-curricular and Extra-curricular Activity)
 Others, _______________________________________________________________

ENDORSEMENT

The Crisis Management Committee endorses the conduct of limited face-to-face

classes/activity/OJT applied by _________________________, as detailed in Form A.

NAME OF THE CMC

DESIGNATION REMARKS SIGNATURE
MEMBER

Institutional
Health Officer

Institutional
Surveillance
Officer

Co-chair

PSAU-OPR-SF-20 | 00 (08-30-22)