Republic of the Philippines

APAYAO STATE COLLEGE

Official website: www.asc.edu.ph
e-mail address: op_asc@yahoo.com
mobile: 0917712282

WFH Form

Name of Employee : _______________________________

Unit/Department : _______________________________
Campus : _______________________________
Name of Head of Unit/Dept.: __________________________
Date of Request for WFH : _______________________________

Month of ______________________, 2021

Date Expected Outputs/Accomplishments Means of Verification (Proof of

Output/Accomplishments

Prepared by:
_____________________________________
Signature of Employee over Printed Name

Recommending Approval:
_____________________________________
Signature of Head of Office over Printed Name

Approved:

Nelia Z. Cauilan, Ph.D.

College President