BATANGAS STATE UNIVERSITY

College of Engineering, Architecture, Fine Arts &

Computing Sciences
Gov. Pablo Borbon Campus II, Alangilan, Batangas City, Philippines 4200
www.batstate-u.edu.ph Telefax: (043) 300-4404 locs. 106-118



I, ___________________, a Chemical/ Food Engineering student hereby voluntary agreed to
conduct a thesis experiments in compliance to ChE 455 (Chemical Engineering Project I) on
___________________, __________ at the Chemical Engineering Laboratory at CEAFACS
building under the following terms of agreement;

; that I shall renounce and waive in my claim against the school/ establishment for any
injury or accident I may suffer.
; that I shall be answerable for any liabilities for damages to property or injury to third
person, which may be occasions by intentional or neglect acts while in the course of the activity.


_____________________ _____________________
Students Signature Parents Signature




_________________________
Thesis Adviser
ChE/FE Department Head



Approved by:


_________________________
Dr. Expedito V. Acorda
Dean, CEAFACS