Republic of the Philippines

Laguna State Polytechnic University

Province of Laguna

THESIS ADVISER NOMINATION

Student/s Name and Signature : ______________________________________________

: ______________________________________________

: ______________________________________________

: ______________________________________________

Degree Sought : ___________________________________________________

Major Field (if applicable) : ___________________________________________________
____________________________________________________________________________

I/we, hereby nominate as Thesis Adviser

Name of Faculty : ________________________________________________

College : ________________________________________________
Field of Specialization : ________________________________________________

I, hereby indicate my willingness to serve as the Thesis Adviser.

Signature of Faculty : _______________________ _________________

Date Signed

Endorsed By: Recommending Approval:

____________________________ _____________________________
Research Coordinator Dean/Associate Dean

APPROVED/DISAPPROVED:

________________________________
R&D Director/Chairperson

LSPU-RDO-SF-011 Rev. 0 8 August 2018