Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Office of the vice president for academic affairs
NATIONAL SERVICE TRAINING PROGRAM OFFICE

May 28, 2024

Dr. MA. LIZA T. YANES

Director
Medical Services Department
This University

Dear Dr. Yanes:

Part of the program of Civic Welfare Training Service 2 is to engage students in the
community through community outreach/off-campus activity.

May I respectfully request the issuance of medical clearance for the students from AB
Philosophy 1-3 for them to conduct an outreach activity at Brgy. 621 Zone 62, District
VI Bacood, Santa Mesa, Manila on June 16, 2024. This clearance is part of the
requirements of the University for community outreach/off-campus activity.

Attached is the master list of the students.

- MEDINA, Ma. Nina Faye M. - ARELLANO, Angelica A.
- MARTINEZ, Resha Leigh - BEBIT, Jercy Rich R.
- ORLEANS, John Dexther N. - MARAVE, Marc Lexter C.
- ALABAN, Danna Marie P. - DOLLENTE, Airene Joy D.
- PORSONA, Darwin R. - UGALE, Hanna Camille M.
- CARLOS, Lois Marevienne B. - LABRO, Kristine Arnelli N.
- LEYCO, Eina Jeniz T. - TAGUMPAY, Jiselle V.
- GELLIDO, Beatrice Anne P. - VILLANUEVA, Angelica D.
- ESTRADA, Izhel M. - PANIS, Jasmin Bea C.

Thank you in anticipation of the approval of this request.

Very truly yours,

Rudolf B. Dela Cruz

Instructor, Civic Welfare Training Service 2

Recommending approval:
MR. JOEY T. DANTING
Chief, Civic Welfare Training Service

DR. ROVELINA B. JACOLBIA

Director, National Service Training
Program

Room E202, Main Building, PUP A. Mabini Campus, Anonas Street, Sta. Mesa, Manila 1016
Trunk Line: 335-1787 or 335-1777 local 305
Website: www.pup.edu.ph |

THE COUNTRY’S 1st POLYTECHNICU