International Affairs Office 

2f CCE Building 
Visca, Baybay City, Leyte, Philippines 
Email Address: i​ ntl@vsu.edu.ph 
Website: www.vsu.edu.ph 

INTERNATIONAL FACULTY / RESEARCHER FORM

Semester [ ] 1​st​ [ ] 2​nd​ [ ] Summer Academic Year:

Home University / Institution:
VSU Department / Office:
Duration of Stay:
Start (dd/mm/yyyy): End (dd/mm/yyyy):

1. PERSONAL INFORMATION

First Name
Last Name
Middle Name
Sex [ ] Male [ ] Female
Nationality
Birthdate (dd/mm/yyyy)
Birthplace
Civil Status [ ] Single [ ] Married [ ] Others:

2. CONTACT INFORMATION

Home Country Address

Philippine Address
E-mail Address
Phone Number

3. EMERGENCY CONTACT INFORMATION

Contact Person in the Philippines

E-mail Address
Phone Number

I hereby declare that the information I have provided above are true and correct.
 International Affairs Office 
2f CCE Building 
Visca, Baybay City, Leyte, Philippines 
Email Address: i​ ntl@vsu.edu.ph 
Website: www.vsu.edu.ph 

_______________________________________ __________________________
SIGNATURE OVER PRINTED NAME DATE