A D M IS S IO N

UNIVERSITY STUDENT SERVICES OFFICE

D E V E LO P M E N T
Visca, Baybay City, Leyte, 6521-A PHILIPPINES

W E L F A R E
VOIP: 1070
Email: usso@vsu.edu.ph
2003 Website: www.vsu.edu.ph

ACTIVITY PERMIT

INSTRUCTIONS:
1. Accomplish this form in four (4) copies and submit to the Student Organization Section In-charge at
least one day (24 hours) before the scheduled activity;
2. Attach financial/budget allocation for any income generating projects and/or activities which require
monetary contributions from members;
3. Attach Parental Consent, Adviser’s and Venue/Community Commitment and other documentary
requirement for off-campus activities; and
4. In case of postponement, cancellation, or change of schedule of the approved activity; the Student
Organization Section must be informed immediately.
=================================================================================
ORGANIZATION:_______________________________________________________________________
NAME OF ACTIVITY:
NATURE OF ACTIVITY: _________________________________________________________________
(socials, educational, work/service, religious, sports/contest, organization development, fund raising, etc.)
PURPOSE(S):_________________________________________________________________________
NO. OF MEMBERS INVOLVED: CONTRIBUTION (if any): P ____ (attached budget allocation)
DATE/S: ________________________________ TIME (from – to) _______________________________
PLACE/VENUE:________________________________________________________________________

Requested by:

_____________________________
Organization President
NOTED BY: (Name and Signature of Advisers)

______________________________
a) _________________________ Committee/Coll./Dept. In-charge

b) _________________________ ______________________________
Bldg./Activity Area In-Charge
=================================================================================
This portion is for USSO

Recommending Approval:

__________________________
Student Organization In-charge
Date:___________
Remarks:
_____________________________________
_____________________________________
_____________________________________
[ ] Approved [ ] Disapproved

_________________________
Dean of Students

Distribution of copies: 1-USSO, 2-Student Organization, 3-Security,

4-Building/Committee/Venue/Community In-charge where activity is to be conducted
Page 1 of 2
Vision: A globally competitive university for science, technology, and environmental conservation.
FM-SSO-29
Mission: Development of a highly competitive human resource, cutting-edge scientific knowledge
v1 00-00-2020
and innovative technologies for sustainable communities and environment. No.
 A D M IS S IO N
UNIVERSITY STUDENT SERVICES OFFICE

D E V E LO P M E N T
Visca, Baybay City, Leyte, 6521-A PHILIPPINES

W E L F A R E
VOIP: 1070
Email: usso@vsu.edu.ph
2003 Website: www.vsu.edu.ph

Page 2 of 2
Vision: A globally competitive university for science, technology, and environmental conservation.
FM-SSO-29
Mission: Development of a highly competitive human resource, cutting-edge scientific knowledge
v1 00-00-2020
and innovative technologies for sustainable communities and environment. No.