Republic of the Philippines

DR. EMILIO B. ESPINOSA, SR. MEMORIAL STATE COLLEGE

OF AGRICULTURE AND TECHNOLOGY
(Masbate State College)
www.debesmscat.edu.ph
Mandaon, Masbate

RELEASE FORM AND PERMIT TO STUDY

Application for the SIKAP Grant

This is to certify that Mr. Wilfred C. Pagorogon is a Full-time Permanent, Teaching

Personnel of the Dr. Emilio B. Espinosa, Sr. Memorial State College of Agriculture and
Technology. He was hired on June 7, 1999 and taught/served in the BS in Information
Systems Program under the College of Arts and Sciences.

Mr. Wilfred C. Pagorogon with the current rank of Associate Professor I has been allowed
to study full-time1 for a period of 3 years, and shall be permitted to take a leave of absence
and shall be released from all institutional responsibilities (teaching and/or administrative
duties) for the entire study duration.

This certificate is issued at the request of Mr. Wilfred C. Pagorogon, and issued this ___
Day of _______________, 2021 to be used for the grant under the CHED Memorandum
Order No. 6, s. 2020, or the Implementing Guidelines for the Scholarship for Instructors’
Knowledge Advancement Program (SIKAP) Grant.

Prepared by:

VINCENT M. CLORES, Ph.D.

Dean, College of Arts and Sciences

Approved by:

RENEE A. LAMELA, Ph.D.

SUC President III

<<Dry Seal, if applicable>>

1 Full-time study - The undertaking of a degree on a full-time basis. The scholar must not have any
teaching load, work load, or administrative load. Further, scholars must not hold employment in a
government agency or private company, which are not HEIs (e.g. State and Local Universities and
Colleges, Private HEIs, etc.)