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PUBLICATION REQUEST FORM

Requesting Unit/Campus: ___________________________________ Date:


_______________

A. Purpose of Publication
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

C. Category of Information (Please check below)

________ Memorandum ________ Photo News

________ Advisory ________ Announcements

________ Policy ________ News/Feature


Article

________ Tarpaulin Lay-out ________ Others, pls specify


____________

D. Where do you want to publish?

________ PSU Echoes ____________ PSU


Facebook Page

_________Local Newspaper ___________ PSU


Website

________ National Newspaper ____________


Tarpaulin

E. Risk if not Published

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

F. Target Date of Publication:


____________________________________________________________

G. Target Audience/Recipients:
___________________________________________________________

H. Name of the Sender: __________________________


Position: ____________________________________

Date: _____________________________________

-------------------------------------- TO BE FILLED IN BY PRPIO PERSONNEL


--------------------------------

H. Evaluation Criteria (Please check)

___________ Relevance

___________ Timeliness

___________ Completeness of Data

I. Action Taken

_____________ Approved

____________ Not Approved Reason/s:


_________________________________________________

K. Received by

Name/Signature: ____________________________________________

Date Received: ______________________________________________

Time Received: ______________________________________________

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