REQUEST FOR Document No.

ALTERNATIVE LEARNING Issue No.

ASSESSMENT Revision No.
Date of Effectivity:
Issued by:
Page No.

Date
THE DIRECTOR
Office of Instruction & Quality Assurance
This University

Thru Channels:

2nd
In lieu of the Midterm/Final Examinations for the ___________ Semester of School year 2022-
2023, I would like to request approval to implement the following Alternative Learning Assessment shown
below:

Course No. Descriptive Title Course/Yr. Alternative Date of Criteria for

& Section Learning Submission/ Evaluation
Assessment Conduct of the
Activity

Thank you very much.

Very truly yours,

Printed Name & Signature of Faculty

RECOMMENDING APPROVAL: ACTION TAKEN:

APPROVED

Department/ Division Chair DISAPPROVED

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Director, Academic Affairs
Dean/School Director