Document Code No.

FM-USTP-OSA-12
Rev. No. Effective Date Page No.

00 10.21.22 1 of 1

STUDENT ACTIVITY REQUEST FORM

ENGR. ERICH P. ABAD, PECE
OIC Vice-Chancellor for Student Affairs and Services
This University

I. NATURE OF ACTIVITY/EVENT: Kindly fill out the necessary data/information.

Date of Activity Application October 3, 2023
Name of the Organization Junior Philippine Society of Mechanical Engineers - USTP Chapter
Name of the Representative Francis B. Ordeniza
Title of Event Monthly Meeting
Type of Event Meeting
(Symposium, Seminar-Workshop, Conference,
Training, Concert, Assembly etc.)
General Objective To conduct a committee orientation and to conduct a meeting for the upcoming events
Specific Objectives

Date of Event October 4, 2023 Hours Duration 5 Start 1:00 PM

End 6:00 PM
# of Participants 51 Venue of Event Bldg 20, Amount Allocated Php 1,500.00
Function Hall
Source of Funds JPSME Funds

II) RECOMMENDATION: [ ] For approval [ ] For Disapproval

Reason/s for Disapproval:

III) RECOMMENDATION: [ ] For approval [ ] For Disapproval

Reason/s for Disapproval:

[ ] AVR ITB [ ] AVR ICT [ ] AVR Engg Complex [ ] Gymnasium [ ] Others (Pls specify) _______________

IV) RECOMMENDATION: [ ] For approval [ ] For Disapproval

Reason/s for Disapproval:

V) RECOMMENDATION: [ ] For approval [ ] For Disapproval

Reason/s for Disapproval:

VI) RECOMMENDATION: [ ] For approval [ ] For Disapproval

Reason/s for Disapproval:

VII) APPROVED: [ ] For approval [ ] For Disapproval

Reason/s for Disapproval:

VIII) APPROVED: [ ] For approval [ ] For Disapproval

Reason/s for Disapproval:

PROVISIONS ON THE CONDUCT OF ANY STUDENT ACTIVITY