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PAMBANSANG KOMISYON PARA SA KULTURA AT MGA SINING

Annex A: Enclosure to the National Committee on Dance,


Pasasalamat sa Sayaw Assistance Program

PASASALAMAT SA SAYAW ASSISTANCE PROGRAM


NCCA-National Committee on Dance

REQUEST FORM

I am a _____________________________________________ whose projects, shows,


(freelance choreographer, dance trainor, dancer, etc)
events, festivals, concerts, other projected engagements and potential sources of income
have been cancelled due to the Enhanced Community Quarantine and the COVID-19
health crisis.

This serves as my intention to request for assistance from the NCCA-NCD Pasasalamat
sa Sayaw Assistance Program.

_____________________________________________
Legal Name (First name, Middle name, Last name)

_________________________________________
Signature

__________________________________________
Mobile Number

__________________________________________
Current Complete Address

PLEASE ATTACH PHOTO OF ID HERE

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