REQUEST FOR ADMINISTERING THE INSTRUMENT FOR DATA

GATHERING FOR THE RESEARCH

Date_____________________

The Dean
College of Criminal Justice Education
This College

Sir:

We, _______________________________, an undergraduate student of EASTERN

SAMAR STATE UNIVERSITY, CAN-AVID CAMPUS, taking up the degree of
________________________ with a major/specialization in
_____________________________ request the member of my advisory committee that we
should be allowed to administer our instrument to gather the necessary data for our thesis.

Major Adviser Name Signature

Members

The signatures opposite each name of the adviser indicate that my advisory
committee is satisfied with the necessary corrections made during the Pre-oral/Oral
examination in the revised Thesis proposal.

Very truly yours,

________________________
Name of Student

Approved:

_______________________
Dean

Date___________________

ESSU-ACAD-904 | Version 4 Page 1 of 1

Effectivity Date: June 10, 2021