OSA Form 2

OSA_UPD Activity Request Form __Revised 2013

OFFICE OF STUDENT ACTIVITIES

Vinzons Hall Annex, UP Diliman QC

ACTIVITY REQUEST FORM (ARF)

Name of Organization

Date of Filing

Title of Activity

Date of Activity

Description of the Activity

Nature of Request

Venue/Area

Inclusive Time and Date (s)

Posting of Posters
Posting of Tarpaulin/s
Police Assistance
Use of University Facilities
Other Request(s)______________
Project/ Program Head

Noted by Faculty Adviser

Name:
College:
Contact No.:
Email:

College:

FOR College-Based Recognized Organization (only)

FOR University-Wide Recognized Organization

________________________________
Signature over printed name

______________________________
Signature over printed name
College Secretary/Assoc. Dean for Student Affairs/
College OSA Coordinator

Dr. MA. ALTHEA T. ENRIQUEZ

Coordinator, Office of Student Activities

RECOMMENDING APPROVAL
Dr. NEIL MARTIAL R. SANTILLAN
Vice Chancellor for Student Affairs

APPROVAL: (for tarpaulin and use of UNIV. facilities)

Dr. NESTOR T. CASTRO
Vice Chancellor for Community Affairs

APPROVAL:
_______________________________________
BUSINESS CONCESSIONS OFFICE

APPROVAL: (for use of COLLEGE

facilities and posting)

__________________________________
DEAN OF COLLEGE

APPROVAL: (for use of university facilities)

________________________________________________
Dorm manager/ College OSA/ Building Administrator