PARENTS PERMIT Off Campus

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OSAS-QF- 25

Republic of the Philippines


CAVITE STATE UNIVERSITY
Don Severino delas Alas Campus
Indang, Cavite

(off-campus activity)

STUDENT INFORMATION

_________________________ _________________________ _____ ____          


Last Name First Name M.I Sex Date of Birth
                 
_____________________________________________________________
Mailing Address Student Number

Contact Number: _______________________ Academic


Non-Academic
Name of Organization: ___________________________________________________________________ Performing Arts
Group

Name of Adviser/s in charge: ____________________________________________ ___________________________________


-----------------------------------------------------------------------------------------------------------------------------
PARENT/GUARDIAN PERMIT/CONSENT

This is to certify that I have full knowledge of and permission for my son/daughter/foster
child to join and participate in:

Title of Activity: ______________________________________________________________________

Date & Time of the Activity: ___________________________________________________________

Place of Activity: ____________________________________________________________________

I concur and agree on the rules, policies & regulations being implemented by the concerned
organizers.

___________________________________ _____________________________
Name & Signature of Parent/Guardian Contact Number

Subscribed & sworn to me this _______day of _______________ 2022 at ________________

vxx-yyyy-mm-dd

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