Republic of the Philippines

Bicol University PARENT(S) / GUARDIAN(S)

OFFICE OF STUDENT AFFAIRS AND SERVICES PERMIT FORM
Legazpi City

PLEASE TAKE NOTE CAREFULLY

1. Please fill up this form in BLOCK LETTERS.
2. ALL sections MUST BE COMPLETED when applicable.
3. Permit should be duly NOTARIZED for Educational Tour/Field Trip purposes and when participant is a minor.
TO WHOM THIS MAY CONCERN
This certifies that ,a
of the INSTITUTE OF DESIGN AND ARCHITECTURE with Student No. has the
permission of his/her undersigned parent(s)/ guardian(s) to participate and/or attend to the
on , 2024 in
.

This certifies further that risk assessment plans and necessary safety and precautionary measures have been instituted.
Further, that the following faculty members shall accompany him/her in the travel.
1.
Faculty Name (Please print) Faculty Signature
2.
3.
4.
5.

Note: If the student is a minor, both parents MUST sign the permission form.
I/ We have honestly and accurately completed all parts of the Parents’/Guardian’s Permit Form to the
best of my/our ability.

Parent/Guardian Signature #1 Date Parent/Guardian Signature #2 Date

Parent/Guardian Name (please print) Parent/Guardian Name (please print)

Complete Address Complete Address

Contact Numbers Contact Numbers

BU OSAS SDSD
BU-F-OSAS-34

Effectivity Date: March 13, 2020 Page 1 of 1

Rev. No. 2