West Visayas State University

(Formerly Iloilo Normal School)

Luna St., La Paz, Iloilo City 5000
Iloilo, Philippines
* Trunkline: (063) (033) 320-0870 to 78 *Telefax No.: (033) 320-0879 Acc. No.: M2700903PM

* Website: * Email Address:

SCP000194Q
OFFICE OF THE PRESIDENT

ANNEX F

(Front) PASS SLIP

_______________________
Date

Name : ___________________________________________________________
Designation : ___________________________________________________________
Destination : ___________________________________________________________
PURPOSE : [] Personal _______________________________________
[ ] Official Business ________________________________
________________________________________________
TIME OUT: _________
TIME-IN: _________
______________________________
Signature

Recommending Approval: Approved:

_______________________ IVY P. CASAMORIN

______________________________
Immediate Supervisor Chief Administrative Officer

(Back) CERTIFICATE OF APPEARANCE

This is to certify that _____________________________________________

of West Visayas State University, appeared in this office on ____________________
for the purpose of ____________________________________________________.

____________________________________
Authorized Official
(Printed Name & Signature)

Position: ____________________________
Date: ______________________________