EVSU-1-ACA-16.036.

0044
Revision No. 00

Republic of the Philippines

EASTERN VISAYAS STATE UNIVERSITY Organization
REVISIN No.00 Tacloban city President
OFFICE OF THE STUDENT AFFAIRS Picture 2x2
ANNUAL REGISTRATION OF CAMPUS ORGANIZATION Recent
SY: ______________

RENEWAL
NEW

NAME OF ORGANIZATION: __________________________________________________________

TYPE OF ORGANIZATION
Course Oriented Service Oriented
Values Oriented Others (Please specify)

OBJECTIVES: (Use additional sheet if necessary)6

1. ______________________________________________________________________________
2. ______________________________________________________________________________
3. ______________________________________________________________________________

OFFICERS:

President: ___________________________ P.R.O/P.I.O: _____________________________

Vice President: ___________________________
Secretary: ___________________________
Asst. Secretary: ___________________________
Treasurer: ___________________________
Auditor: ___________________________
Business Manager: ________________________
1st YR. Representative: ____________________
2nd YR. Representative: ____________________
3nd YR. Representative: ____________________
4nd YR. Representative: ____________________

President Contact No.: _________________

Vice President Contact No.: _________________

ADVISERS: (Signature over Printed Name)

__________________________________ _______________________________

Submitted by:

___________________________________
Signature over Printed Name

Recommending Approval:

_________________________________ SONIA T. ENRILE, MAED

Dean, OIC, Head, Office of Student Affairs

FAUSTITO A. AURE, MRD DENNIS C. DE PAZ, Ph.D.

Dean of Students Vice President, Academic Affairs

Approved:

DOMINADOR O. AGUIRRE, JR. D.M.

University President