AGREEMENT FORM

Name: _____________________________________ Date: _________________________

Program, Major, Year Level, Section: ________________________________________
Course Enrolled: ___________________________________________________________
(Course Number and Course Title)
Address: __________________________________________________________________
(Sitio-Barangay-Municipality/City-Province)
Contact Number(s): _______________________________________________________
E-mail Address: ____________________________________________________________

Mode of Learning (Choose only one):

_________________________ MODULAR LEARNING

(Signature over printed name)

_________________________ ONLINE LEARNING

(Signature over printed name)

For Modular Learning:

Option 1: Option 2:

Willing to print the module and any Prefer to have a hardcopy and pick
assessment papers on your own up the module and any assessment
expense as long as the professor papers in school.
provides the softcopy of the
module.
___________________________
___________________________ Signature over printed name
Signature over printed name

For Online Learning

- Modules will be sent via Interaction Network (e-mail or other means).
- Access to virtual classroom (stable internet connectivity and availability of gadgets)

Agreement between:

______________________________ and ___________________________

Signature over printed name Course Facilitator