UNIVERSITY OF ANTIQUE Document No: CEA-BF-008

Sibalom, Antique 5713 Philippines Revision No.: 00

Telefax: (036)5438161 Effective Date: January 2016
Email: ua@antiquespride.edu.ph
Copy: 1 of 1

_______________________
Date

DR. PABLO S. CRESPO, JR.

Vice President for Academic Affairs

Sir:

The undersigned would like to request for the tutorial offering of the subject/course (________)
Course Code

___________________________________ for students with deficiencies this ______ semester,

Descriptive Title

SY 20___ – 20___.

Listed below are the students who have expressed their intent to enroll in the course.

Name of Student Year & Section

1. _____________________________________________ _____________________
2. _____________________________________________ _____________________
3. _____________________________________________ _____________________
4. _____________________________________________ _____________________
5. _____________________________________________ _____________________
6. _____________________________________________ _____________________
7. _____________________________________________ _____________________
8. _____________________________________________ _____________________
9. _____________________________________________ _____________________
10. _____________________________________________ _____________________
11. _____________________________________________ _____________________
12. _____________________________________________ _____________________
13. _____________________________________________ _____________________
14. _____________________________________________ _____________________
15. _____________________________________________ _____________________

I look forward to your favorable action on this request.

Respectfully yours:

_______________________________________
Dean

Approved:

PABLO S. CRESPO, JR., Ph.D

VP, Academic Affairs