Bicol University

(COLLEGE)
NSTP- Civic Welfare Training Service
Legazpi City

FORM 3

CONSENT OF PARENT OR GUARDIAN

I, _______________________________________________________________ of legal age, residing at
(Name)

_________________________________________________________ and parent/guardian/ward of Mr./Ms.

(Address)
_________________________________________ student of the___________________________ do hereby
(Name of Student) (College/Unit)

authorize him/her to undertake NSTP field immersion at

____________________________________________________ from_______________________ to ________________.
(Place of Immersion)
I understand that my son/daughter_________________________________ will be guided by the
College and University rules on Student Conduct as if he/she is in campus and also by
pertinent rules and regulations of the community.
a) I agree to my son/ daughter taking part of the Field Immersion Program as
requirement for the completion of NSTP 2 to give an opportunity for real time exposure
and interaction in the community , to equip and empower them on the fundamentals of
project identification, planning and implementation in pursuit to the contribution to the
upliftment of the general welfare and the quality of life of the people in the community
through enhancement, in particular of the school and community facilities especially
those that are devoted to improving health, education, safety, livelihood, environment,
entrepreneurship, safety, recreation, morale of the citizenry, and other social welfare
service.

b) I agree that the college and the faculty supervisor will not be held liable to my
son/daughter beyond the scheduled time of barangay immersion and that No Faculty
supervisor, No Baranggay Immersion is observed.

c) I understand that my son/daughter will undergo an 30 hours Immersion to the

assigned Community/Barangay.

d) I hereby further agree to support and give necessary support for all personal and
incidental expenses that may be incurred by my daughter/son in connection with this
(off-campus field work) required for the successful completion of his/her immersion
program.

In witness hereof, I have hereinto signed this consent this _______________ day of
___________________ at ___________________.

____________________________________________________
Signature Over Printed Name
(Parent/Guardian)
______________________________
Contact No.