WAIVER

May 07, 2022

TO: __Ms. Mary Ann Misa____

NSTP CWTS Trainor

In support of the Republic Act 9163 otherwise known as the NSTP Act of 2001 and in
recognition of the vital role of the youth in nation-building, by this instrument, we convey
that we fully understood that our son/daughter is about to perform and participate in the
community immersion and other NSTP related activities to satisfy the requirements of the
law and complete the NSTP-Civic Welfare Training Service 2/Literacy Training Service 2.

Rest assured that all safety measures and precautions will be made during the entire
schedule. Hence, the responsibility of the University is only limited and not to any incident
beyond control caused by which his/her failure to follow all warnings, advice, and
instructions. We also clearly understood that we absolve the Technological University of the
Philippines and National Service Training Program-CWTS/LTS Officials, Faculty, and Staff
from any obligation due to uncertainties.

We, therefore, allow our son/daughter Ferdinand A. Pagaran Jr.

(name)
of BSIE-ICT 1D to participate on this worthy undertaking for the period they are
(course)
immersed with the HOME/nearby community only from May to June 2022.

Jane Ramos 09358460591

Signature over printed name Contact Number of Guardian
(Lagda sa ibabaw ng pangalan)

Auntie______
Relationship/kaugnayan

Ferdinand A. Pagaran Jr. 09266201978

Name of Student/Pangalan ng Mag-aaral Contact number of Student

BSIE-ICT 1D
Course and Section